Increasing rates of malarial fever with deteriorating immune status in HIV-1-infected Ugandan adults
Increasing rates of malarial fever with deteriorating immune status in HIV-1-infected Ugandan adults
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DOI：
10.1097/00002030-200105040-00010
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发表时间：
2001-05-04
期刊：
影响因子：
3.8
通讯作者：
Gilks, CF
中科院分区：
文献类型：
--
作者：
French, N;Nakiyingi, J;Gilks, CF
背景：恶性疟和HIV-1感染是撒哈拉以南非洲地区面临的两个最重要的健康问题。没有令人信服的证据表明症状性疟疾和HIV-1感染之间存在关联。目的：研究HIV相关免疫抑制对疟疾发热率的影响。设计：在乌干达恩德培的HIV特异性初级保健诊所进行的一项观察性队列研究，研究对象是参加23价肺炎球菌疫苗随机试验的1371名HIV-1感染成人。方法：队列成员接受了6个月的常规监测，并在生病时开放诊所。根据标准化方案评估发热发作。结果：恶性疟发病率与CD 4 T细胞计数呈显著负相关，CD 4 T细胞< 200、200-499和> 500者分别为140、93和57例/1000 pyo，P< 0.001。疟疾发热定义纳入寄生虫密度标准（来自无症状监测），以纠正机会发现发热和恶性疟原虫寄生虫病，并没有影响关联的发病率与immunosuppress.Conclusion：这些数据支持症状恶性疟原虫和HIV之间的相互作用。强调避蚊措施应成为疟疾流行地区艾滋病毒/艾滋病患者教育和咨询的一个重要组成部分，这表明非洲存在另一个与艾滋病毒有关的公共卫生问题。(C)2001年利平科特威廉姆斯&威尔金斯。
Background: Falciparum malaria and HIV-1 infection are two of the most important health problems facing sub-Saharan Africa. No convincing evidence of an association between symptomatic malaria and HIV-1 infection has been found.Objective: To investigate the effect of HIV-associated immunosuppression on malarial fever rates.Design: An observational cohort study in HIV-specific, primary healthcare clinics in Entebbe, Uganda, on 1371 HIV-1-infected adults participating in a randomized trial of 23-valent pneumococcal vaccine.Methods: Cohort members underwent routine 6 monthly surveillance and had open clinic access when sick. Episodes of fever were assessed according to standardized protocols. Rates of malaria are described according to HIV immune status determined by CD4 T cell counts.Results: Incidence rates of Plasmodium falciparum malarial fever showed a marked inverse relationship with CD4 T cell count; 140, 93 and 57 cases per 1000 pyo for CD4 T cell groups < 200, 200-499 and > 500 respectively, P< 0.001. Malarial fever definitions incorporating parasite density criteria (derived from asymptomatic surveillance) to correct for chance findings of fever and P. falciparum parasitaemia, did not affect the association of incidence rates with immunosuppression.Conclusion: These data support an interaction between symptomatic P. falciparum and HIV. Emphasis on mosquito avoidance measures should be an important component of education and counselling of HIV/AIDS patients in malaria-endemic areas, and suggests an additional HIV-related public health problem in Africa. (C) 2001 Lippincott Williams & Wilkins.