FREQUENCIES OF OPPORTUNISTIC DISEASES PRIOR TO DEATH AMONG HIV-INFECTED PERSONS
FREQUENCIES OF OPPORTUNISTIC DISEASES PRIOR TO DEATH AMONG HIV-INFECTED PERSONS
复制标题
DOI：
10.1097/00002030-199510000-00005
复制
发表时间：
1995-10-01
期刊：
影响因子：
3.8
通讯作者：
OSTERBERGER, J
中科院分区：
文献类型：
--
作者：
CHAN, ISF;NEATON, JD;OSTERBERGER, J
目的：描述 1883 名 HIV 感染者在死亡前和死亡 6 个月内经历的主要机会性事件的完整历史，并确定特定事件的频率是否根据人口特征、风险行为或地理位置而变化。设计：描述性病例系列。方法：1990 年 9 月至 1994 年 6 月期间，共有 6682 名 HIV 感染者参加了艾滋病临床研究社区计划资助的研究， 1883年在随访期间死亡。通过结合入组时获得的病史数据、随访期间发生的新事件以及死亡原因，确定了这些患者的完整艾滋病定义事件史。结果：这 1883 名患者在死亡前经历的最常见机会性艾滋病定义事件是卡氏肺囊虫肺炎 (PCP；45%)、鸟分枝杆菌复合体 (MAC；25%)、消耗综合征 (25%)、细菌肺炎（24%）、巨细胞病毒（CMV）病（23%）和念珠菌病（食管或肺部；22%）。此外，47%的患者在死亡前经历过两次或三次艾滋病定义事件，22%的患者经历过四次或更多事件。在死亡前6个月，22%的患者患有PCP，21%患有MAC，20%患有CMV疾病。发现了显着的性别和种族差异：与男性相比，女性在死亡前更容易发生细菌性肺炎；患卡波西肉瘤 (KS) 的黑人和拉丁裔人数少于白人；死前患有巨细胞病毒疾病的黑人比白人少。患有 KS 和 CMV 的患者比例也因危险行为而异。调整人口特征和危险行为后，10 种机会性疾病的发生频率因地理区域而异。值得注意的是，美国东北部的结核病患者较多，而 MAC 患者较少。结论：很大一部分 HIV 感染者在死亡前经历过多种艾滋病定义的机会性疾病。 PCP、MAC、消耗综合征、细菌性肺炎、CMV 疾病和念珠菌病（食道或肺部）占 HIV 感染相关发病率的很大一部分。更多的疾病因地理位置而异，而不是因人口特征或患者的危险行为而异。继续研究这些疾病的病因和预防以及它们之间的相互关系应该是当务之急。
Objectives: To describe the complete history of major opportunistic events experienced by 1883 HIV-infected persons prior to and specifically within 6 months of death, and to determine whether the frequency of specific events varies according to demographic characteristics, risk behaviors or geographic location.Design: Descriptive case series.Methods: Of 6682 HIV-infected individuals enrolled in studies sponsored by the Community Programs for Clinical Research on AIDS between September 1990 and lune 1994, 1883 died during follow-up. A complete history of AIDS-defining events was determined for these patients by combining medical history data obtained at the time of enrollment, new events that occurred during follow-up, and causes of death.Results: The most common opportunistic AIDS-defining events these 1883 patients experienced before death were Pneumocystis carinii pneumonia (PCP; 45%), Mycobacterium avium complex (MAC; 25%), wasting syndrome (25%), bacterial pneumonia (24%), cytomegalovirus (CMV) disease (23%) and candidiasis (esophageal or pulmonary; 22%). in addition, 47% of patients experienced two or three AIDS-defining events before death, and 22% experienced four or more events. In the 6 months prior to death, 22% of patients had PCP, 21% had MAC, and 20% had CMV disease. Significant sex and ethnic differences were found: bacterial pneumonia occurred more often before death in women compared with men; fewer blacks and Latinos than whites experienced Kaposi's sarcoma (KS); and fewer blacks than whites had CMV disease before death. The percentage of patients with KS and CMV also varied by risk behavior. The frequency of 10 opportunistic diseases varied by geographic region after adjustment for demographic characteristics and risk behavior. Of note, many more patients in northeastern USA had tuberculosis and fewer had MAC.Conclusion: A large percentage of individuals with HIV infection experienced multiple AIDS-defining opportunistic diseases before death. PCP, MAC, wasting syndrome, bacterial pneumonia, CMV disease, and candidiasis (esophageal or pulmonary) account for a substantial proportion of morbidity associated with HIV infection. More diseases varied by geographic location than by demographic characteristics or risk behavior of patients. Continued research on the etiology and prevention of these diseases and how they relate to one another should be a high priority.