Perez-Perdomo R, Perez-Cardona C M, Suarez-Perez E L
University of Puerto Rico, Graduate School of Public Health, San Juan.
AIDS Patient Care STDS. 1999 Nov;13(11):651-8. doi: 10.1089/apc.1999.13.651.
The objective of this study was to describe the AIDS-defining conditions (ADC) and survival experience of pediatric AIDS cases (< 13 years age) reported in Puerto Rico. A descriptive analysis of the data gathered by the Puerto Rico AIDS Surveillance System was performed. Data for the 377 pediatric AIDS cases reported from January 1981 through June 1998 were reviewed. Survival curves following AIDS diagnosis were estimated using the Kaplan--Meier method and differences between curves were assessed by the Wilcoxon test. The majority (61%) of the cases were diagnosed before 2 years of age, and nearly 94% of them acquired the infection through perinatal transmission. The most common ADC were Pneumocystis carinii pneumonia (PCP) (23%), wasting syndrome (19.4%), and esophageal candidiasis (19.1%). The overall median survival time during the study period was 53.5 (95% CI: 38.0-106.2) months. Children < 1 year of age had a significantly shorter median survival time compared with older ages (p < 0.05). The survival experience in children diagnosed with PCP, pulmonary candidiasis, cytomegalovirus, and lymphocytic interstitial pneumonia (LIP) was significantly different (p < 0.05) to those children not diagnosed with these conditions. Although patients diagnosed after 1990 showed a median survival time longer than those diagnosed prior to 1990, the difference did not reach statistical significance (p > 0.05). The frequency of several ADC and median survival time of Puerto Rican children differed from those reported in the United States. This may reflect differences in diagnostic procedures or reporting practices.
本研究的目的是描述波多黎各报告的儿童艾滋病病例（年龄<13岁）的艾滋病界定条件（ADC）及生存情况。对波多黎各艾滋病监测系统收集的数据进行了描述性分析。回顾了1981年1月至1998年6月期间报告的377例儿童艾滋病病例的数据。采用Kaplan-Meier方法估计艾滋病诊断后的生存曲线，并通过Wilcoxon检验评估曲线之间的差异。大多数（61%）病例在2岁前被诊断，其中近94%通过围产期传播感染。最常见的ADC是卡氏肺孢子虫肺炎（PCP）（23%）、消瘦综合征（19.4%）和食管念珠菌病（19.1%）。研究期间的总体中位生存时间为53.5（95%CI：38.0-106.2）个月。<1岁的儿童中位生存时间明显短于年龄较大的儿童（p<0.05）。诊断为PCP、肺念珠菌病、巨细胞病毒和淋巴细胞间质性肺炎（LIP）的儿童的生存情况与未诊断出这些疾病的儿童有显著差异（p<0.05）。尽管1990年后诊断的患者中位生存时间长于1990年前诊断的患者，但差异未达到统计学意义（p>0.05）。波多黎各儿童的几种ADC发生率和中位生存时间与美国报告的不同。这可能反映了诊断程序或报告做法的差异。
