艾滋病毒感染者的侵入性肺炎球菌病:巴西的一项回顾性病例对照研究
Roxana Flores Mamani1, Tiago de Assunção López2, Waldir Madany Jalo1
1Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil.
Tropical medicine and infectious disease
|June 27, 2023
概括
侵入性肺炎球菌病 (IPD) 仍然是艾滋病毒/艾滋病感染者 (PLWHA) 的重大威胁,尽管抗逆转录病毒疗法 (ART) 存在高发病率和死亡率. 肝硬化和酒是该人口中IPD和死亡的关键风险因素.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 免疫学 免疫学 免疫学
背景情况:
- 艾滋病毒/艾滋病 (PLWHA) 感染者面临侵袭性肺炎球菌病 (IPD) 的风险增加.
- 了解PLWHA中IPD和相关死亡率的风险因素对于有针对性的干预至关重要.
研究的目的:
- 描述PLWHA中的IPD病例,并确定感染和死亡的相关风险因素.
- 评估2005年至2020年期间巴西PLWHA中IPD的发病率.
主要方法:
- 在巴西 (2005-2020年) 的PLWHA队列中进行了一项回顾性病例控制研究.
- 针对IPD的病例与没有IPD的对照人群进行了比较,根据年龄,性别和研究地点进行了匹配.
- 分析了临床特征,并发症,治疗和结果的数据.
主要成果:
- IPD的发生率为964/100,000人/年. 肺炎和细菌病是常见的表现.
- 在单变量分析中,肝硬化和COPD与IPD相关;在多变量分析中,没有任何因素是显著的.
- 死亡率为21.1%,与酒,肝硬化,较低的CD4计数,血小板缩小,低蛋白血症,高带形状,肌素和AST相关.
结论:
- 尽管抗逆转录病毒疗法 (ART),但IPD发病率在PLWHA中仍然很高.
- 观察到肺炎球菌疫苗接种率较低 (19%).
- 肝硬化和酒是IPD和PLWHA患者死亡率的重要风险因素.
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