Increased incidence of meningococcal disease in HIV-infected individuals associated with higher case-fatality ratios in South Africa
Increased incidence of meningococcal disease in HIV-infected individuals associated with higher case-fatality ratios in South Africa
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DOI：
10.1097/qad.0b013e32833a2520
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发表时间：
2010-06-01
期刊：
影响因子：
3.8
通讯作者：
von Gottberg, Anne
中科院分区：
文献类型：
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作者：
Cohen, Cheryl;Singh, Elvira;von Gottberg, Anne
目的：我们旨在比较HIV感染者和未感染者脑膜炎球菌病的发病率，并评估HIV是否是脑膜炎球菌病患者死亡和菌血症的危险因素。设计：队列监测研究。方法：我们在南非豪登省对脑膜炎球菌病进行了实验室监测。在哨点获得艾滋病毒状况和结果数据。艾滋病毒感染者和未感染者发病率的计算假定在接受检测和未接受检测的个人中按年龄划分的艾滋病毒流行率相似。使用多变量logistic回归评估死亡和菌血症（与脑膜炎相比）的危险因素。结果：2003 - 2007年共报告脑膜炎球菌病例1336例。在已知结果的504例哨点患者中，308例（61%）有HIV血清状态数据。脑膜炎球菌病病例中的艾滋病毒流行率高于所有年龄组的人口艾滋病毒流行率。在所有年龄组中，艾滋病毒感染者脑膜炎球菌病的发病率均升高，年龄调整相对危险度为11.3[95%可信区间（CI） 8.9-14.3， P
Objectives: We aimed to compare the incidence of meningococcal disease amongst HIV-infected and uninfected individuals and to evaluate whether HIV is a risk factor for mortality and bacteremia amongst patients with meningococcal disease.Design: Cohort surveillance study.Methods: We conducted laboratory-based surveillance for meningococcal disease in Gauteng Province, South Africa. HIV status and outcome data were obtained at sentinel sites. Incidence in HIV-infected and uninfected persons was calculated assuming a similar age-specific HIV prevalence in tested and untested individuals. Risk factors for death and bacteremia (as compared with meningitis) were evaluated using multivariable logistic regression.Results: From 2003 to 2007, 1336 meningococcal cases were reported. Of 504 patients at sentinel sites with known outcome, 308 (61%) had HIV serostatus data. HIV prevalence amongst cases of meningococcal disease was higher than the population HIV prevalence in all age groups. The incidence of meningococcal disease in HIV-infected individuals was elevated in all age groups with an age-adjusted relative risk of 11.3 [95% confidence interval (CI) 8.9-14.3, P