PLASMODIUM-FALCIPARUM MALARIA AND PERINATALLY ACQUIRED HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION IN KINSHASA, ZAIRE - A PROSPECTIVE, LONGITUDINAL COHORT STUDY OF 587 CHILDREN
PLASMODIUM-FALCIPARUM MALARIA AND PERINATALLY ACQUIRED HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION IN KINSHASA, ZAIRE - A PROSPECTIVE, LONGITUDINAL COHORT STUDY OF 587 CHILDREN
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DOI：
10.1056/nejm199107113250206
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发表时间：
1991-07-11
影响因子：
158.5
通讯作者：
HASSIG, SE
中科院分区：
文献类型：
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作者：
GREENBERG, AE;NSA, W;HASSIG, SE
背景目前尚不确定恶性疟原虫疟疾是否在围产期获得性人类免疫缺陷病毒1型（HIV-1）感染的儿童中更常见或更严重，以及恶性疟原虫感染是否加速HIV相关疾病的进展。我们在扎伊尔金沙萨进行了一项前瞻性纵向队列研究。在13个月的时间里，对260名5至9个月大、母亲为艾滋病毒1型血清反应阳性的儿童和327名同龄、母亲为血清反应阴性的儿童进行了疟疾强化监测。所有的发热事件都通过血涂片进行疟疾评估，发现感染恶性疟原虫的儿童用口服奎宁的标准方案进行治疗。共评估了2899例发热病例，确定了271例疟疾病例。在四组明确定义的儿童中，疟疾的发病率、严重程度或对治疗的反应没有统计学显著差异：患有获得性免疫缺陷综合征（AIDS）的儿童、在整个研究中HIV-1血清阳性的儿童、由HIV-1血清阳性母亲所生但恢复为血清阴性的儿童以及在整个研究中血清阴性的儿童。在13个月的时间里，36名感染艾滋病毒并发展为艾滋病的儿童的疟疾发病率低于37名未发展为艾滋病的儿童，尽管差异不显著。在这项研究中，在进行性HIV-1感染的儿童中，疟疾并没有更频繁或更严重，疟疾似乎没有加速HIV-1疾病的进展速度。
Background. It is uncertain whether Plasmodium falciparum malaria is more frequent or more severe in children with perinatally acquired human immunodeficiency virus type 1 (HIV-1) infection and whether P. falciparum infection accelerates the progression of HIV-related disease.Methods. We conducted a prospective, longitudinal cohort study in Kinshasa, Zaire. Two hundred sixty children 5 to 9 months of age who had been born to HIV-1-seropositive mothers and 327 children of the same age who had been born to seronegative mothers were monitored intensively for malaria over a 13-month period. All episodes of fever were evaluated with blood smears for malaria, and children found to be infected with P. falciparum were treated with a standard regimen of oral quinine.Results. A total of 2899 fevers were evaluated, with 271 cases of malaria identified. No statistically significant differences were found in the incidence, severity, or response to therapy of malaria among four well-defined groups of children: those with the acquired immunodeficiency syndrome (AIDS), those who were HIV-1-seropositive throughout the study, those who were born to HIV-1-seropositive mothers but reverted to seronegative, and those who were seronegative throughout the study. During the 13-month period the incidence of malaria in the 36 children with HIV infection in whom AIDS developed was lower, although not significantly so, than in the 37 in whom AIDS did not develop.Conclusions. In this study malaria was not more frequent or more severe in children with progressive HIV-1 infection and malaria did not appear to accelerate the rate of progression of HIV-1 disease.