在艾滋病毒感染患者中使用可纳来预防密码球菌脑膜炎的初级预防
V J Quagliarello1, C Viscoli, R I Horwitz
1Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, USA.
Lancet (London, England)
|March 4, 1995
概括
口服可纳显著降低了低CD4计数的HIV感染患者第一个密码球菌脑膜炎发作的风险. 这种抗真菌药物可以有效地保护这种严重的机会性感染.
科学领域:
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病研究研究
- 菌类学 菌类学是指菌类学.
背景情况:
- 加密球菌脑膜炎是艾滋病毒感染个体的危及生命的机会性感染,特别是那些CD4细胞数量低于250/microL的患者.
- 预防机会性感染对于治疗艾滋病毒/艾滋病患者至关重要.
研究的目的:
- 调查口服可纳在预防艾滋病毒感染患者初始发生的加密球菌脑膜炎的疗效.
- 为了确定弗卢科纳暴露是否与脆弱的艾滋病毒阳性人群中加密球菌脑膜炎风险降低有关.
主要方法:
- 进行了一项病例控制研究,涉及HIV感染患者的CD4计数<250/microL.
- 病例是患有密码球菌脑膜炎的患者,而对照组的脑脊液密码球菌检测结果为阴性,并与人口统计和临床因素相匹配.
- 评估了诊断前六个月内口服可纳的暴露情况.
主要成果:
- 与对照组相比 (11%) 的病例比例明显较低 (36%),接受过口服可纳的治疗.
- 可纳暴露与92%降低了患上加密球菌脑膜炎的风险相关 (匹配几率比=0.08,p=0.035).
- 在病例和对照群之间的基线特征中没有观察到任何显著差异,除了可纳暴露.
结论:
- 口服弗卢可纳在HIV感染患者中具有显著的保护效果,可预防第一个密码球菌脑膜炎发作,CD4计数<250/microL.
- 虽然没有确定最佳剂量,但研究结果表明,非日常使用可纳可以有效预防.
- 这些结果支持在这个患者群体中考虑使用可纳作为对加密球菌脑膜炎的初级预防.
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