艾滋病毒患者神经病的危险因素:一项回顾性队列研究
Beatriz Arns1, Tarsila Vieceli1, Eduardo Gomes2
1Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre, RS, Brazil.
概括
在人类免疫缺陷病毒 (HIV) 患者中,高梅毒 (VDRL) 标位 (≥1:32) 和高病毒载量 (>400副本/毫米3) 会增加神经梅毒的风险. 对于这些人来说,推进行腰椎穿刺查.
科学领域:
- 传染性疾病 传染性疾病
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 梅毒是一种全球性传播感染,在人类免疫缺陷病毒 (HIV) 患者中患病率增加.
- 目前的指导方针建议腰部穿刺仅用于症状神经,在艾滋病毒患者中可能缺少无症状病例.
- 确定额外的风险因素对于针对性地对艾滋病毒感染个体进行神经查至关重要.
研究的目的:
- 确定与艾滋病毒感染患者神经发育相关的风险因素.
- 为临床实践提供信息,以了解这种脆弱人群中神经的查策略.
主要方法:
- 在2011年至2021年期间进行了一项回顾性队列研究.
- 包括确诊梅毒的成年艾滋病毒患者,不包括未接受治疗,低VDRL标位 (≤1:4),其他神经疾病或非艾滋病毒相关的免疫抑制.
- 在梅毒诊断后,患者被跟踪了两年.
主要成果:
- 该研究包括140名患有190次梅毒的患者;平均年龄为45.0岁,79.3%是男性.
- 较高的血清VDRL标位 (≥1:32) 和神经症状的存在与神经显著相关.
- 人类免疫缺陷病毒 (HIV) 病毒载量≤400副本/毫米3被发现是对神经的保护因素.
结论:
- 血清VDRL标位≥1:32和HIV病毒载量>400副本/mm3是HIV患者神经病的重要危险因素.
- 这些发现表明,在具有这些风险因素的艾滋病毒患者中,即使没有神经症状,也应该考虑诊断腰部穿刺.
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