南非儿童感染艾滋病毒的加密球菌抗原病
Alison Gifford1, Rudzani Mashau2,3, Ruth Mpembe2
1Department of Biosciences, Faculty of Life and Health Sciences, MRC Centre for Medical Mycology, University of Exeter, Exeter, UK.
The Pediatric infectious disease journal
|January 28, 2026
概括
低CD4细胞计数的南非儿童的密码球菌抗原 (CrAg) 查显示患病率为4.7%,与成年人相比. 将CrAg查扩展到所有儿童身上,可以显著改善结果,并减少由密码球菌脑膜炎引起的死亡率.
科学领域:
- 儿童传染病 儿童传染病
- 艾滋病毒/艾滋病研究研究
- 临床微生物学 临床微生物学
背景情况:
- 加密球菌脑膜炎 (CM) 对儿童,尤其是感染艾滋病毒的儿童构成重大威胁.
- 目前世界卫生组织的指导方针不建议在10岁以下的儿童中进行CrAg查.
- 南非对所有年龄段的人进行查,CD4计数低于100细胞/μL.
研究的目的:
- 为了确定南非儿童中cd4计数<100细胞/μL的加密球菌抗原血症的患病率.
- 为了评估CRAg阳性儿童的临床结果.
- 为了提供有关儿童群体CrAg查的指导方针.
主要方法:
- 对国家卫生实验室服务记录 (2017-2022) 的回顾性分析.
- 包括CD4<100细胞/μL和CrAg查结果的儿童 (<18岁).
- 详细的临床信息从15个设施的Crag阳性和匹配的Crag阴性儿童的方便样本中收集.
主要成果:
- 在18岁以下的儿童 (平均年龄14岁) 中,CRAg总体患病率为4.7%.
- 在10岁以下的儿童中,患病率为3.5%.
- 49%的CRAg阳性儿童有脑膜炎症状;33%的儿童被诊断为CM. 19%的crAg阳性儿童经历了6个月死亡率. 与没有治疗相比,先发性可纳治疗减少了CM诊断.
结论:
- 在CD4<100细胞/μL的儿童中,CrAg的患病率与成年人相似.
- 目前的CrAg查指南应该扩大到包括所有儿童.
- 在儿童中进行普遍的CrAg查可以改善结果并减少CM相关的死亡率.
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