Holding K J, Dworkin M S, Wan P C, Hanson D L, Klevens R M, Jones J L, Sullivan P S
Epidemiology Program Office, Division of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Prevention, National Center for Human Immunodeficiency Virus, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2000 Nov;31(5):1253-7. doi: 10.1086/317452. Epub 2000 Nov 6.
Aspergillosis is a life-threatening fungal infection in immunocompromised people, including people infected with human immunodeficiency virus (HIV). We determined the incidence of aspergillosis among HIV-infected people and survival after aspergillosis diagnosis by use of a national HIV surveillance database. Among 35,252 HIV-infected patients, the incidence of aspergillosis was 3.5 cases per 1000 person-years (p-y; 95% confidence interval [CI], 3.0-4.0 per 1000 p-y). Incidence was higher among people aged > or =35 years (4.1 per 1000 p-y, 95% CI, 3. 5-4.8), among people with CD4 counts of 50-99 cells/mm(3) (5.1 per 1000 p-y, 95% CI, 2.8-7.3), or CD4 counts of <50 cells/mm(3) (10.2 per 1000 p-y, 95% CI, 8.0-12.2), versus people with CD4 counts of >200 cells/mm(3), people with > or =1 acquired immune deficiency syndrome-defining opportunistic illness (8.6 per 1000 p-y, 95% CI, 7.4-9.9), and people who were prescribed at least one medication associated with neutropenia (27.7 per 1000 p-y, 95% CI, 21.0-34.3). Median survival time after diagnosis of aspergillosis was 3 months, and 26% survived for > or =1 year. These findings suggest that aspergillosis is uncommon, occurs especially among severely immunosuppressed or leukopenic HIV-infected people, and is associated with poor survival.
曲霉病是一种危及免疫功能低下人群生命的真菌感染，包括感染人类免疫缺陷病毒（HIV）的人群。我们利用一个全国性HIV监测数据库确定了HIV感染者中曲霉病的发病率以及曲霉病诊断后的生存率。在35252例HIV感染患者中，曲霉病的发病率为每1000人年3.5例（95%置信区间[CI]，每1000人年3.0 - 4.0例）。年龄≥35岁的人群发病率更高（每1000人年4.1例，95%CI，3.5 - 4.8），CD4细胞计数为50 - 99个/立方毫米的人群（每1000人年5.1例，95%CI，2.8 - 7.3），或CD4细胞计数＜50个/立方毫米的人群（每1000人年10.2例，95%CI，8.0 - 12.2），而CD4细胞计数＞200个/立方毫米的人群、患有≥1种获得性免疫缺陷综合征定义的机会性疾病的人群（每1000人年8.6例，95%CI，7.4 - 9.9）以及至少服用一种与中性粒细胞减少相关药物的人群（每1000人年27.7例，95%CI，21.0 - 34.3）发病率较低。曲霉病诊断后的中位生存时间为3个月，26%的患者存活≥1年。这些发现表明曲霉病并不常见，尤其发生在严重免疫抑制或白细胞减少的HIV感染人群中，且与生存率低相关。
