COCCIDIOIDOMYCOSIS DURING HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - RESULTS OF A PROSPECTIVE-STUDY IN A COCCIDIOIDAL ENDEMIC AREA
COCCIDIOIDOMYCOSIS DURING HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - RESULTS OF A PROSPECTIVE-STUDY IN A COCCIDIOIDAL ENDEMIC AREA
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DOI：
10.1016/0002-9343(93)90054-s
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发表时间：
1993-03-01
影响因子：
5.9
通讯作者：
GALGIANI, JN
中科院分区：
文献类型：
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作者：
AMPEL, NM;DOLS, CL;GALGIANI, JN
目得：为了确定活动性球孢子菌病的发病率与人类免疫缺陷病毒（HIV）感染的受试者生活在一个地区流行的球孢子菌病，并确定与这些患者的活动性球孢子菌病的发展相关的因素，患者和方法：这是一个前瞻性队列分析的HIV感染的受试者生活在一个地区流行的球孢子菌病在亚利桑那州。在入组时和每隔约4个月，对受试者进行访谈和检查，并进行球蛋白皮肤试验和CD 4淋巴细胞计数以及沿着其他试验。在每一个时间间隔，它是确定是否受试者已制定活动性球孢子菌病根据既定的criterions.RESULTS：一百七十名受试者进入研究。中位随访时间为11.3个月（范围：0 - 44个月）。13例受试者发生活动性球孢子菌病，41个月时估计累积发生率为24.6%（95%置信限为8.2%和41.1%）。队列中与活动性球孢子菌病发展相关的危险因素是CD 4淋巴细胞计数低于0.250 × 10（9）/L和诊断为获得性免疫缺陷综合征。与先前的球孢子菌感染，包括一个积极的球蛋白皮肤试验，居住在流行区超过25个月的时间长度，以及先前的球孢子菌病的历史，相关的因素，是不相关的发展活动infection.CONCLUSION：活动性球孢子菌病感染艾滋病毒的个人之间是常见的球孢子菌病流行区。免疫缺陷似乎是疾病发展的主要危险因素。先前球孢子菌病的证据，包括球蛋白皮肤试验阳性，似乎不能预测活动性感染的发展。
PURPOSE: To determine the incidence of active coccidioidomycosis among subjects infected with the human immunodeficiency virus (HIV) living in an area endemic for coccidioidomycosis and to identify factors associated with the development of active coccidioidomycosis in these patients,PATIENTS AND METHODS: This was a prospective cohort analysis of HIV-infected subjects living in an area endemic for coccidioidomycosis in Arizona. On entry and at approximately 4-month intervals, subjects were interviewed and examined, and had spherulin skin testing and CD4 lymphocyte counts performed along with other tests. During each interval, it was determined whether the subject had developed active coccidioidomycosis according to established criteria.RESULTS: One hundred seventy subjects entered the study. Median follow-up was 11.3 months (range: 0 to 44 months). Thirteen subjects developed active coccidioidomycosis with an estimated cumulative incidence of 24.6% by 41 months (95% confidence limits 8.2% and 41.1%). Risk factors associated with the development of active coccidioidomycosis in the cohort were a CD4 lymphocyte count of less than 0.250 X 10(9)/L and a diagnosis of acquired immunodeficiency syndrome. Factors associated with prior coccidioidal infection, including a positive spherulin skin test, length of residence in the endemic area for more than 25 months, and a prior history of coccidioidomycosis, were not associated with the development of active infection.CONCLUSION: Active coccidioidomycosis among individuals infected with HIV is common in the coccidioidal endemic area. Immunodeficiency appears to be the major risk factor for the development of disease. Evidence of prior coccidioidomycosis, including a positive spherulin skin test, does not appear to predict the development of active infection.