The spectrum of HIV‐1-related disease among outpatients in New York City
The spectrum of HIV‐1-related disease among outpatients in New York City
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纽约市门诊患者的 HIV-1 相关疾病谱
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
R. F. Evans
中科院分区：
文献类型：
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作者：
A. Greenberg;P. Thomas;S. Landesman;D. Mildvan;M. Seidlin;G. Friedland;R. Holzman;B. Starrett;J. Braun;E. Bryan;R. F. Evans
目的：明确纽约市（NYC）与HIV - 1相关疾病的范围，并确定不同人群中疾病的临床范围有何差异。
设计与方法：回顾性审查了1989年在四家医院门诊诊所和两名私人医生诊所接受治疗的2983名HIV感染者的病历。
结果：61%的研究患者以及1989年就诊的患者中有48%患有艾滋病。感染HIV的女性患艾滋病以及CD4淋巴细胞计数<200×10⁶/升的可能性明显低于男性。1989年每100名艾滋病患者中，有88名非艾滋病患者CD4计数<500×10⁶/升，其中41名CD4计数<200×10⁶/升；因此，除了估计纽约市有16425名艾滋病患者外，我们估计至少有14454名未患艾滋病但CD4计数<500×10⁶/升的HIV感染者，其中6734名CD4计数<200×10⁶/升。男同性恋者患卡波西肉瘤、巨细胞病毒病和视网膜炎、隐孢子虫病和淋巴瘤的可能性明显高于静脉吸毒者，而患卡氏肺孢子虫肺炎、食管念珠菌病、肺外结核（TB）和细菌性肺炎的可能性明显低于静脉吸毒者。白人患肺结核的可能性明显低于西班牙裔、非海地裔和海地裔黑人，患弓形虫病的可能性明显低于西班牙裔和海地裔黑人，患沙门氏菌败血症的可能性明显低于非海地裔黑人。大多数诊断的频率没有性别差异；本研究中女性病历中很少记录妇科疾病。
结论：这些数据表明，纽约市有30000多名患有严重免疫抑制的成年HIV感染者，纽约市艾滋病病例中女性所占比例将不断增加，并且与HIV相关的疾病谱在不同人群中差异显著。
Objectives.To define the spectrum of HIV-1 -related disease in New York City (NYC) and to determine how the clinical spectrum of illness differs in various populations. Design and methods.The medical records of the 2983 HIV-infected individuals who had received care through 1989 at four hospital outpatient clinics and two private physicians' offices were reviewed retrospectively. Results.Sixty-one per cent of the study patients and 48% of patients seen in 1989 had AIDS. HIV-infected women were significantly less likely to have AIDS and CD4 lymphocyte counts < 200 x 106/I than men. For every 100 AIDS patients seen in 1989, there were 88 non-AIDS patients with CD4 counts < 500 x 106/I, of whom 41 had CD4 counts < 200 x 106/I; thus, in addition to an estimated 16425 individuals living with AIDS in NYC, we estimate that there are at least 14454 HIV-infected individuals without AIDS with CD4 counts < 500 x 106/I, of whom 6734 have CD4 counts < 200 x 106/l. Men who have sex with men were significantly more likely to have Kaposi's sarcoma, cytomegalovirus disease and retinitis, cryptosporidiosis and lymphoma, and significantly less likely to have Pneumocystis carinii pneumonia, esophageal candidiasis, extrapulmonary tuberculosis (TB) and bacterial pneumonia than intravenous drug users. Whites were significantly less likely to have pulmonary TB than Hispanics, non-Haitian and Haitian blacks, toxoplasmosis than Hispanics and Haitian blacks, and salmonella septicemia than non-Haitian blacks. The frequencies of most diagnoses did not differ by sex; gynecologic diseases were recorded infrequently in the medical records of women in this study. Conclusions.These data indicate that there are more than 30000 HIV-infected adults living in NYC with significant immunosuppression, that an increasing proportion of AIDS cases in NYC will occur among women, and that the spectrum of HIV-related disease varies markedly in different populations.