HIVに感染した乳児の出生後2年の間における下痢の罹患率
K L Kotloff1, J P Johnson, P Nair
1Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore 21201.
JAMA
|February 9, 1994
まとめ
ヒト免疫不全ウイルス (HIV) に感染した乳児は,感染していない乳児よりも下痢を多く経験します. これらの乳児の持続的な下痢は,重度のHIV疾患の進行と機会性感染症の増加を示しています.
科学分野:
- 小児の感染症について
- 免疫学 免疫学とは
- ウイルス学 ウイルス学 ウイルス学
背景:
- ヒト免疫不全ウイルス (HIV) を生前感染した乳児は,様々な健康上の合併症に敏感です.
- 腹は幼少期の一般的な懸念であり,その影響は免疫不全の乳児では増幅される可能性があります.
研究 の 目的:
- 生後2年の幼児における下痢の発生率,原因,パターンを調査する.
- HIVに感染した乳児の下痢疾患を,HIVに感染していない乳児の下痢疾患と比較する.
主な方法:
- 縦断的なコホート研究では,58人の乳児 (18人がHIV感染者,40人がHIV感染者ではない) を,出生から15ヶ月までの期間で追跡した.
- 2週間に1度,下痢の発生に関する監視が行われました.
- 糞便のサンプルを腸病原体のために分析し,HIV状態が確認されました.
主要な成果:
- HIVに感染した乳児は,感染していない乳児と比較して,下痢の発生率が有意に高かった (3.2エピソード/12子供月) (1.5エピソード/12子供月).
- 持続的な下痢 (≥14日) は,HIVに感染した乳児においてより頻繁であり,より重度のHIV感染 (CD4+数値の低下,より機会性感染症) と関連していました.
- 下痢のピーク発生率は,HIV感染した乳児 (0~5ヶ月) で,未感染の乳児 (6~11ヶ月) よりも早く発生した.
結論:
- 急性下痢と持続性下痢は,HIVに感染した乳児における罹病率の重要な源である.
- 持続的な下痢は,乳児におけるHIV疾患の急速な進行のための重要な臨床マーカーとして機能します.
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