预测性疾病的失败的Pneumocystis carinii肺炎的预防. 多中心艾滋病队列研究
1Johns Hopkins University, School of Public Health, Baltimore, Md., 21205, USA.
JAMA
|April 19, 1995
概括
深度T助手淋巴细胞衰竭是肺囊肺炎 (PCP) 在HIV-1患者的预防失败的主要预测因素. 对于T助手计数低于0.100 x 10(9) /L的情况,需要改进预防方法.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 肺囊性肺炎 (PCP) 仍然是人类免疫缺陷病毒1型 (HIV-1) 感染个体的重大机会性感染.
- 预防对于预防PCP至关重要,但影响其失败的因素需要进一步调查.
研究的目的:
- 在接受初级或二级预防的HIV-1感染个体中,确定与PCP预防失败相关的临床和流行病学因素.
- 为制定更有效的预防策略提供信息.
主要方法:
- 在多中心艾滋病队列研究中,对476名HIV-1感染者进行了纵向队列研究.
- 预防方案的分析,包括trimethoprim-sulfamethoxazole (TMP-SMX),达普森和气溶中的胺胺.
- 对T辅助淋巴细胞数量和其他临床因素的时间依赖分析.
主要成果:
- 尽管进行了预防,但20%的参与者出现了PCP.
- 深度T助手淋巴细胞衰竭 (计数<0.075 x 10(9) /L) 是预防失败的主要预测因素.
- 发烧也预测了随后的PCP,而TMP-SMX显示了保护作用.
结论:
- 目前的PCP预防方案对于严重免疫抑制的个体来说是不够的 (T-helper计数<0.100 x 10(9) / L).
- 有必要制定更有效的预防方案来预防PCP在这个高风险人群中.
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