Invasive pneumococcal disease in a cohort of HIV-infected adults: incidence and risk factors, 1990-2003
Invasive pneumococcal disease in a cohort of HIV-infected adults: incidence and risk factors, 1990-2003
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DOI：
10.1097/01.aids.0000206507.54901.84
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发表时间：
2006-02-14
期刊：
影响因子：
3.8
通讯作者：
Lucas, GM
中科院分区：
文献类型：
--
作者：
Barry, PM;Zetola, N;Lucas, GM
目的：探讨HAART的引入与HIV感染者侵袭性肺炎球菌病（IPD）之间的关系。方法：在1990年至2003年的HIV感染者队列中确定IPD的发病率，并进行巢式病例对照研究评估IPD的危险因素。有72例病例随访超过19 020人年（总体IPD率为379/100 000人年）。在1990-1995年、1995-1998年和1998-2003年期间，每10万人-年的IPD发病率分别为279 [95%置信区间（CI），150-519]、377（95% CI，227-625）和410（95% CI，308-545）（P = 0.516）。CD 4细胞计数< 200个细胞/μ l [比值比（OR），3.0; 95%CI，1.2-7.6），HIV RNA > 50 000拷贝/ml（OR，2.8; 95% CI，1.2-6.5），丙型肝炎（OR，4.9; 95% CI，1.7-14.9），血清白蛋白（OR，0.1; 95% CI，0.04-0.5），女性注射用药多因素分析显示，IPD与年龄、性别、性别、年龄、性别、年龄、性别、年龄、性别、年龄、性别没有治疗因素，包括HAART（OR，0.7; 95%CI，0.3-1.5）和肺炎球菌疫苗接种（OR，0.9; 95%CI，0.5-1.6），与IPD。结论：IPD发病率没有显着改变HAART在这个队列中的广泛传播。IPD风险与几个社会人口统计学和临床因素相关。(C)2006年利平科特威廉姆斯&威尔金斯。
Objective: To investigate the association between the introduction of HAART and invasive pneumococcal disease (IPD) in HIV-infected patients.Methods: Incidence of IPD was determined from 1990 to 2003 in a cohort of HIV-infected individuals and a nested case-control study assessed risk factors of IPD.Results: There were 72 cases over 19 020 person-years of follow-up (overall IPD rate, 379/100 000 person-years). In the calendar periods 1990-1995, 1995-1998, and 1998-2003, the IPD incidence per 100 000 person-years was 279 [95% confidence interval (CI), 150-519], 377 (95% CI, 227-625) and 410 (95% CI, 308-545), respectively (P = 0.516). CD4 cell count < 200 cells/mu l [odds ratio(OR), 3.0; 95% CI, 1.2-7.6), HIV RNA > 50 000 copies/ml (OR, 2.8; 95% CI, 1.2-6.5), hepatitis C (OR, 4.9; 95% CI, 1.7-14.9), serum albumin (OR, 0.1; 95% CI, 0.04-0.5), injection drug use in women (OR, 3.8; 95% CI, 1.6-8.8), and education beyond high school (OR, 0.2; 95% CI, 0.05-0.8) were significantly associated with IPD in multivariate analysis. No treatment factor, including HAART (OR, 0.7; 95% CI, 0.3-1.5) and pneumococcal vaccination (OR, 0.9; 95% Cl, 0.5-1.6), was associated with IPD.Conclusions: IPD incidence did not change significantly during the widespread dissemination of HAART in this cohort. IPD risk was associated with several sociodemographic and clinical factors. (C) 2006 Lippincott Williams & Wilkins.