CONTRIBUTION OF TUBERCULOSIS TO SLIM DISEASE IN AFRICA
CONTRIBUTION OF TUBERCULOSIS TO SLIM DISEASE IN AFRICA
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DOI：
10.1136/bmj.308.6943.1531
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发表时间：
1994-06-11
影响因子：
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通讯作者：
KADIO, A
中科院分区：
文献类型：
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作者：
LUCAS, SB;DECOCK, KM;KADIO, A
目的 - 评估结核病对非洲艾滋病毒消耗综合征（苗条）病因学的贡献，这种疾病通常被认为是一种肠病。方法 - 对艾滋病毒阳性成年患者进行临床检查和代表性尸检研究。地点 - 科特迪瓦阿比让医院内科病房。受试者 - 艾滋病毒阳性成人。主要结果指标 - 死亡前 CD4 T 淋巴细胞计数、临床和人体测量数据以及总体和体格数据。显微病理学。结果——对 212 名 HIV 阳性成年人进行了尸检。 93 名患有临床 HIV 消耗综合症的人中有 41 人发现了结核病，119 名没有临床 HIV 消耗综合症的人中有 32 人发现了结核病（比值比 2.1，95% 置信区间 1.2 至 4.0）。尸检时结核病患病率与尸体消瘦程度之间存在显着相关性（无消瘦 25%（15/59）；中度消瘦 40%（23/58）；骨骼消瘦 44%（42/95）；P=0.02）。消瘦也与慢性腹泻病史有关，但腹泻和结核病之间不存在关联。无论尸检结果如何，消瘦患者和慢性腹泻患者的中位 CD4 T 淋巴细胞计数最低。
Objectives-To assess the contribution of tuberculosis to the aetiology of the HIV wasting syndrome (slim) in Africa, a condition usually considered an enteropathy.Methods-Clinical examination and representative necropsy study of adult patients positive for HIV.Setting-Hospital medical wards in Abidjan, Ivory Coast.Subjects-Adults positive for HIV.Main outcome measures-CD4 T lymphocyte counts before death, clinical and anthropometric data, and gross and microscopic pathology.Results-Necropsy was done on 212 HIV positive adults. Tuberculosis was found in 41 of 93 with the clinical HIV wasting syndrome and in 32 of 119 without (odds ratio 2.1, 95% confidence interval 1.2 to 4.0). A significant association existed between the prevalence of tuberculosis at necropsy and the degree of cadaveric wasting (no wasting 25% (15/59); moderate wasting 40% (23/58); skeletal wasting 44% (42/95); P=0.02). Wasting was also associated with a history of chronic diarrhoea, but no association existed between diarrhoea and tuberculosis. Median CD4 T lymphocyte counts were lowest in wasted patients irrespective of findings at necropsy and in those with chronic diarrhoea (