艾滋病毒感染者的神经感染:流行病学和临床模式的转变
Miranda Mengyuan Wan1, M John Gill2,3,4, Kevin Fonseca4,5
1Department of Clinical Neurosciences.
AIDS (London, England)
|September 13, 2023
概括
神经系统感染,无论是艾滋病确定的还是非艾滋病确定的,在艾滋病毒感染者 (PWH) 中仍然存在. 早期诊断和抗逆转录病毒治疗 (ART) 对于预防这些感染和降低死亡率至关重要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 神经感染对艾滋病毒感染者 (PWH) 构成重大威胁.
- 了解这些感染的流行病学和风险因素对于有效管理至关重要.
- 抗逆转录病毒疗法 (ART) 已经改变了艾滋病毒治疗,但神经系统并发症仍然可能出现.
研究的目的:
- 确定PWH中艾滋病定义和非艾滋病定义的神经感染的发病率,风险因素和临床结果.
- 分析这些感染发生的趋势随着时间的推移.
- 为了确定与神经系统感染和死亡率的风险增加相关的患者特征.
主要方法:
- 追溯观察队列研究,链接临床,医院和微生物学数据库.
- 从1995年到2018年,在艾滋病毒感染者 (PWH) 中识别神经系统感染.
- 使用考克斯比例危险模型进行统计分析,以确定风险因素和死亡结果.
主要成果:
- 133个神经系统感染 (4.6%) 发生在2910个PWH,超过24,237个人年.
- 艾滋病确定的感染数量下降,而非艾滋病确定的感染数量保持稳定.
- 黑人PWH和CD4+T细胞值<200细胞/μL的人有更高的风险.
- 神经系统感染与发作,中风以及所有原因和艾滋病毒相关死亡率的增加有关.
结论:
- 神经系统感染,无论是艾滋病确定的还是非艾滋病确定的,都继续影响PWH.
- 这些感染与大量的发病率和死亡率有关.
- 及时诊断和启动ART对于预防PWH的神经学并发症至关重要.
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