艾滋病毒阴性免疫缺陷患者的脑炎:一个前性的多中心研究,法国,2016年至2019年
Sophie Landré1, Florence Ader1,2, Olivier Epaulard3,4
1University Claude Bernard Lyon 1, Hospices Civils de Lyon, Infectious disease department, Lyon, France.
概括
感染性脑炎在免疫缺陷 (ID) 患者中更为严重,而疹病毒是最常见的原因. 免疫缺陷独立地增加了脑炎病例中不良结果的风险.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 免疫缺陷 (ID) 个体感染性脑炎的数据有限.
- 糖尿病患者可能表现出非典型的症状,不常见的病原体和更糟糕的结果.
- 了解艾滋病毒阴性ID患者脑炎流行病学至关重要.
研究的目的:
- 描述HIV负免疫缺陷 (ID) 患者感染性脑炎的流行病学.
- 为了比较ID的临床表现,成像,生物发现,原因和结果与免疫能力 (IC) 脑炎患者.
- 评估免疫缺陷作为感染性脑炎不良结果的风险因素.
主要方法:
- 来自潜在ENCEIF队列的患者分析 (2016年1月至2019年12月).
- 在ID和IC脑炎患者之间比较临床,MRI,生物,病因和结局数据.
- 后勤回归用于确定免疫缺陷是否是不良结果的风险因素.
主要成果:
- 与IC患者 (n=436) 相比,ID患者 (n=58) 年龄较大,并患有更多的并发病 (糖尿病,神经障碍) 和较高的病例死亡率 (23.6%).
- 疹病毒是ID患者 (25.9%) 的首要原因,比IC患者 (11.5%) 更频繁.
- 免疫缺陷是死亡或重大后果的独立风险因素 (OR: 3.41,95% CI: 1.70-6.85).
结论:
- 疹病毒是免疫缺陷患者感染性脑炎的最常见原因.
- 免疫缺陷是脑炎不良结果的重要独立风险因素.
- 脑炎的ID患者需要彻底的病因调查和及时的经验治疗.
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