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Updated: May 30, 2025

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艾滋病毒阳性患者晚期骨折相关感染:一个前性队列研究

Simon M Graham^1,2,3,4, Samuel Masterson⁵, Maritz Laubscher^3,4

¹Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK.

The bone & joint journal

|January 31, 2025

概括

这项研究发现,HIV感染在下肢骨折手术后增加了晚期骨折相关感染 (FRI) 的风险. 然而,艾滋病毒状态并没有显著影响这个南非队列的早期FRI率.

科学领域:

整形外科手术整形外科手术
传染性疾病传染性疾病
在LMICs的公共卫生.

背景情况:

肌肉骨损伤和艾滋病毒不成比例地影响低收入和中等收入国家 (LMIC).
骨折在艾滋病毒阳性个体中很常见,但长期的结果,特别是与骨折相关的感染 (FRIs),尚不清楚.
这项研究解决了在接受下肢骨折固定治疗的患者中艾滋病毒和FRI之间的关联方面的知识差距.

研究的目的:

调查人类免疫缺陷病毒 (HIV) 感染与骨折相关感染 (FRI) 在下肢骨折的内钉固定后的发生之间的关联.
要区分早期 (<90天) 和晚期 (>90天) 的FRI与艾滋病毒状况相关.
分析艾滋病毒对南非第三级医院环境中的整体和特定时间的FRI率的影响.

主要方法:

在南非开普敦进行了一项前性队列研究,358名成年患者接受了下肢骨折固定治疗.
参与者被监测了至少24个月的早期和晚期FRI的发展.
记录了艾滋病毒状况,并使用统计分析,包括单变量和多变量回归来评估艾滋病毒和FRI之间的关联.

主要成果:

在完成研究的325名参与者中,37人 (11.4%) 发展了39个FRI. 71名艾滋病毒阳性参与者中有15人 (21.1%) 患有16次FRI,而254名艾滋病毒阴性参与者中有22人 (8.7%) 患有23次FRI.
与HIV阴性个体相比,HIV阳性个体患晚期FRI (7.0%对2.0%) 和整体FRI的可能性明显更高.
在艾滋病毒阳性和艾滋病毒阴性参与者之间没有观察到早期FRI发生率的显著差异.

结论:

这项研究表明,艾滋病毒感染与晚期骨折相关感染的风险增加之间存在显著的关联.
与一些现有文献相反,这项研究强调了HIV阳性患者骨折后晚发性感染的特定风险.
早期FRI发病率没有受到艾滋病毒状态的显著影响,这表明早期和晚期感染发展的病理生理路径不同.

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