Morbidity and nutritional impairment in relation to CD4 count in a Zambian population with high HIV prevalence
Morbidity and nutritional impairment in relation to CD4 count in a Zambian population with high HIV prevalence
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DOI：
10.1016/s0001-706x(02)00095-5
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发表时间：
2002-08-01
期刊：
影响因子：
2.7
通讯作者：
Farthing, MJG
中科院分区：
文献类型：
--
作者：
Kelly, P;Zulu, I;Farthing, MJG
艾滋病毒的流行大大增加了许多非洲城市的发病率，严重营养不良是临床表现的一个突出特点。然而，在人口水平上，关于发病率或营养状况与免疫损伤之间的关系的资料很少。我们报告一项横断面研究的发病率和营养状况与CD 4计数在一个贫困的城市社区在卢萨卡，赞比亚，在登记进入一个纵向研究。在1999年的两个月内，对居住在一个地区的506名成年人中的261人（52%）进行了访谈和检查。在186名同意接受检测的成年人中，65名HIV血清阳性者中有33名（51%）报告了疾病症状，而121名HIV血清阴性者中有39名（32%）报告了疾病症状（OR 2.2，95%CI 1.1-4.2; P = 0.02）。HIV血清阴性个体的外周血CD 4计数与发达国家的标准大致相似，但8例（7%）的CD 4计数低于500个细胞/穆尔。艾滋病毒血清阳性成年人的发病率以结核病（n = 11）、其他呼吸道感染（5）或持续性腹泻（4）为主，受影响的个体的CD 4计数范围很广。在有机会性感染临床证据的HIV血清阳性成年人中，营养障碍明显，而无症状HIV感染者则无营养障碍。出乎意料的是，我们还注意到，收缩压在HIV感染者和OI患者中逐渐降低。总之，艾滋病毒相关的发病率主要是少数可治疗的传染病发生在广泛的CD 4计数。营养障碍与OI相关。(C)2002 Elsevier Science B. V.保留所有权利。
The HIV epidemic has greatly increased morbidity in many African cities and severe undernutrition is a prominent feature of the clinical presentation. However, there is little information about the relationship of morbidity or nutritional status to immune damage at a population level. We report a cross-sectional study of morbidity and nutritional status in relation to CD4 count in an impoverished urban community in Lusaka, Zambia, at enrolment into a longitudinal study. Over a 2 month period in 1999, 261 (52%) of 506 adults resident in one area were interviewed and examined. Of 186 adults who consented to testing, 33 (51%) of 65 who were HIV seropositive reported symptoms of disease compared to 39 (32%) of 121 who were HIV seronegative (OR 2.2, 95% CI 1.1-4.2; P = 0.02). Peripheral blood CD4 counts in HIV seronegative individuals were broadly similar to norms in developed countries, but 8 (7%) had CD4 counts below 500 cells/mul. Morbidity in HIV seropositive adults was dominated by tuberculosis (n = 11), other respiratory infections (5) or persistent diarrhoea (4), and affected individuals had a wide range of CD4 counts. Nutritional impairment was evident in HIV seropositive adults with clinical evidence of opportunistic infection (01), not those with asymptomatic HIV infection. Unexpectedly, we also noted that systolic blood pressure was reduced progressively in HIV infection and in those with OI. In conclusion, HIV-related morbidity was dominated by a small number of treatable infectious diseases occurring over a wide range of CD4 count. Nutritional impairment was associated with OI. (C) 2002 Elsevier Science B.V. All rights reserved.