Baboo K S, Luo N P, Murphy J R, Cummings C, Chintu C, Ustianowski A, DuPont H L, Kelinowski M, Mathewson J J, Zumla A
Department of Community Medicine, University Teaching Hospital, Lusaka, Zambia.
J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Feb 1;20(2):160-3. doi: 10.1097/00042560-199902010-00008.
The seroprevalence of HIV-1 in sub-Saharan African patients with diarrhea in the community remains largely unknown. We present the findings of a 2-month study that we undertook to ascertain the seroprevalence of HIV-1 in Zambian patients presenting with acute diarrhea in a community-based health center. A total of 256 patients with diarrhea and 140 apparently healthy controls was seen. Of the patients with diarrhea, 161 were < 16 years old and 95 were adults. Most children with diarrhea were < 6 years old (147 of 161; 91%). Overall, 81 of 256 (32%) patients with diarrhea were HIV-1-seropositive. When results from children < 18 months old and possibly having maternal anti-HIV-1 antibodies were excluded, 64 of 172 (37%) patients with diarrhea were HIV-seropositive. Rates of HIV-1 seropositivity for patients with diarrhea were significantly higher than were rates for diarrhea-free controls (p < .001 for both the total population; odds ratio [OR], 95% confidence interval [CI], 1.42 < 2.48 < 4.35) and population > 18 months old (OR, 95% CI, 1.54 < 2.90 < 5.49). Among children between 18 months and 5 years old, 14 of 63 (22%) were HIV-1-seropositive compared with 8 of 62 (13%) without diarrhea (p > .05, not significant). Moreover, 49 of 95 (52%) adults with acute diarrhea were HIV-1-seropositive compared with 10 of 44 (23%) healthy adult controls (p < .003; OR, 95% CI, 1.51 < 3.62 < 8.87). No significant differences were found in HIV-1 seroprevalence rates between males and females in all age groups. These data show a close association between acute diarrhea and HIV seropositivity in Zambian adults in the community.
撒哈拉以南非洲社区腹泻患者中HIV-1的血清流行率在很大程度上仍不清楚。我们介绍了一项为期2个月的研究结果，该研究旨在确定赞比亚一家社区卫生中心出现急性腹泻患者中HIV-1的血清流行率。共诊治了256例腹泻患者和140例看似健康的对照者。腹泻患者中，161例年龄小于16岁，95例为成年人。大多数腹泻儿童年龄小于6岁（161例中的147例；91%）。总体而言，256例腹泻患者中有81例（32%）HIV-1血清学阳性。排除18个月以下可能有母体抗HIV-1抗体的儿童的结果后，172例腹泻患者中有64例（37%）HIV血清学阳性。腹泻患者的HIV-1血清阳性率显著高于无腹泻对照者（总体人群p<0.001；优势比[OR]，95%置信区间[CI]，1.42<2.48<4.35）以及18个月以上人群（OR，95%CI，1.54<2.90<5.49）。在18个月至5岁的儿童中，63例中有14例（22%）HIV-1血清学阳性，而无腹泻的62例中有8例（13%）（p>0.05，无显著性差异）。此外，95例急性腹泻成年人中有49例（52%）HIV-1血清学阳性，而4�例健康成年对照者中有10例（23%）（p<0.003；OR，95%CI，1.51<3.62<8.87）。所有年龄组中，男性和女性的HIV-1血清流行率未发现显著差异。这些数据表明赞比亚社区成年人中急性腹泻与HIV血清阳性之间存在密切关联。
