The changing epidemiology of cryptococcosis: An update from population-based active surveillance in 2 large metropolitan areas, 1992-2000
The changing epidemiology of cryptococcosis: An update from population-based active surveillance in 2 large metropolitan areas, 1992-2000
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DOI：
10.1086/368091
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发表时间：
2003-03-15
影响因子：
11.8
通讯作者：
Hajjeh, RA
中科院分区：
文献类型：
--
作者：
Mirza, SA;Phelan, M;Hajjeh, RA
为了研究隐球菌病的发病率和流行病学趋势，1992-2000年在美国2个地区（格鲁吉亚亚特兰大和得克萨斯州休斯顿，大都市区;总人口740万）进行了积极的、基于人群的监测。共发现1 491例事件，其中1 322例（89%）为艾滋病毒感染者。在研究期间，每1000名艾滋病患者中隐球菌病的年发病率显著下降，亚特兰大地区从1992年的66例下降到2000年的7例，休斯顿地区从1993年的24例下降到1994年的2例。Poisson回归分析显示，非裔美国人艾滋病患者比白色艾滋病患者更容易患病。不到三分之一的艾滋病毒感染隐球菌病的人在诊断前接受抗逆转录病毒治疗。我们的研究结果表明，在美国高效抗逆转录病毒治疗（HAART）时代继续发展隐球菌病的HIV感染者是那些获得医疗保健机会有限的人。需要作出更多努力，扩大向这些人提供高效抗逆转录病毒疗法和常规艾滋病毒护理服务。
To examine trends in the incidence and epidemiology of cryptococcosis, active, population-based surveillance was conducted during 1992-2000 in 2 areas of the United States (the Atlanta, Georgia, and Houston, Texas, metropolitan areas; combined population, 7.4 million). A total of 1491 incident cases were detected, of which 1322 (89%) occurred in HIV-infected persons. The annual incidence of cryptococcosis per 1000 persons with AIDS decreased significantly during the study period, from 66 in 1992 to 7 in 2000 in the Atlanta area, and from 24 in 1993 to 2 in 1994 in the Houston area. Poisson regression analysis revealed that African American persons with AIDS were more likely than white persons with AIDS to develop disease. Less than one-third of all HIV-infected persons with cryptococcosis were receiving antiretroviral therapy before diagnosis. Our findings suggest that HIV-infected persons who continue to develop cryptococcosis in the era of highly active antiretroviral therapy (HAART) in the United States are those with limited access to health care. More efforts are needed to expand the availability of HAART and routine HIV care services to these persons.