Incidence of neutropenia in HIV-infected African adults receiving co-trimoxazole prophylaxis: a 6-year cohort study in Abidjan, Cote d'Ivoire
Incidence of neutropenia in HIV-infected African adults receiving co-trimoxazole prophylaxis: a 6-year cohort study in Abidjan, Cote d'Ivoire
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DOI：
10.1016/j.trstmh.2005.11.008
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发表时间：
2006-08-01
影响因子：
2.2
通讯作者：
Anglaret, Xavier
中科院分区：
文献类型：
--
作者：
Toure, Siaka;Gabillard, Delphine;Anglaret, Xavier
在科特迪瓦进行的复方新诺明预防性治疗的安慰剂对照试验中，中性粒细胞减少症是最常见的短期副作用。在撒哈拉以南非洲成年人接受复方新诺明的中性粒细胞减少症的长期发病率从未报道。我们跟踪了阿比让接受复方新诺明（磺胺甲恶唑800 mg/甲氧苄啶160 mg，每日一次）的HIV感染成人前瞻性队列。中性粒细胞减少的分级依次定义为至少一个中性粒细胞绝对计数（ANC）：≥ 1）、≥ 2）、≥ 3）或≥ 1，≥ 2级为0.64（95% CI 0.60-0.71），≥ 3级为0.82（95% CI 0.77-0.86），4级为0.96（95% CI 0.93-0.99）。与所有级别中性粒细胞减少症发生率较高显著相关的唯一因素是基线CD 4计数较低。在研究期间，任何级别的中性粒细胞减少症与严重发病率的总体风险之间均无相关性。在阿比让接受复方新诺明的成人中，轻度中性粒细胞减少症是常见的观察结果，没有证据表明会产生不良临床后果。应仔细评估复方新诺明与其他血液毒性药物联合使用的后果。(C)2006年皇家热带医学和卫生学会。由Elsevier Ltd.出版。保留所有权利。
In a placebo-controlled trial of co-trimoxazole prophylaxis in Cote d'lvoire, neutropenia was the most frequent short-term side effect. The long-term incidence of neutropenia in sub-Saharan African adults receiving co-trimoxazole has never been reported. We followed a prospective cohort of HIV-infected adults receiving co-trimoxazole (sulphamethoxazole 800 mg/trimethoprim 160 mg daily) in Abidjan. Grades of neutropenia were successively defined as at least one absolute neutrophil count (ANC) of: = 1), = 2), = 3) or = 1, 0.64 (95% Cl 0.60-0.71) for grade >= 2, 0.82 (95% Cl 0.77-0.86) for grade >= 3 and 0.96 (95% Cl 0.93-0.99) for grade 4. The only factor significantly associated with a higher rate of all grades of neutropenia was a tow baseline CD4 count. There was no association between any grade of neutropenia and the global risk of serious morbidity during the study period. In adults receiving co-trimoxazole in Abidjan, mild neutropenia is a common observation with no evidence of negative clinical consequences. The consequences of associating co-trimoxazole with other haematotoxic drugs should be carefully assessed. (C) 2006 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.