Wilson Lucy E, Thomas David L, Astemborski Jacqueline, Freedman Terri L, Vlahov David
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
J Infect Dis. 2002 Jun 15;185(12):1761-6. doi: 10.1086/340827. Epub 2002 May 31.
To determine the effect of human immunodeficiency virus (HIV) infection and other factors on infective endocarditis (IE) among injection drug users (IDUs), the incidence of IE was determined according to HIV status in a cohort of IDUs. A nested case-control study assessed IE risk factors. IE incidence (117 cases) was higher among HIV-seropositive than HIV-seronegative IDUs (13.8 vs. 3.3 cases/1000 person-years) during 1988-1998. Multivariate analysis of HIV-infected case patients revealed an inverse association between IE and CD4 lymphocyte count (odds ratio [OR] for 200-499 cells/mm(3), 2.01; OR for <200 cells/mm(3), 3.61) and with alcohol intake (OR for 1-21 drinks/week, 0.43; OR for >21 drinks/week, 0.32). Women had an increased risk of IE (OR, 3.26), as did persons with increasing injection drug use frequency (OR for less than daily use, 3.15; OR for at least daily use, 6.07). This study confirms that IE is more common among IDUs with advanced HIV immunosuppression even after accounting for injection drug use behaviors.
为确定人类免疫缺陷病毒（HIV）感染及其他因素对注射吸毒者（IDU）感染性心内膜炎（IE）的影响，根据HIV感染状况在一组注射吸毒者中确定了IE的发病率。一项巢式病例对照研究评估了IE的危险因素。在1988 - 1998年期间，HIV血清阳性的注射吸毒者中IE发病率（117例）高于HIV血清阴性者（分别为13.8例/1000人年和3.3例/1000人年）。对HIV感染的病例患者进行多变量分析发现，IE与CD4淋巴细胞计数呈负相关（CD4淋巴细胞计数为200 - 499个细胞/mm³时，比值比[OR]为2.01；CD4淋巴细胞计数＜200个细胞/mm³时，OR为3.61），与饮酒量也呈负相关（每周饮酒1 - 21次时，OR为0.43；每周饮酒＞21次时，OR为0.32）。女性患IE的风险增加（OR为3.26），注射吸毒频率增加的人也是如此（注射频率低于每日一次时，OR为3.15；注射频率至少每日一次时，OR为6.07）。这项研究证实，即使考虑到注射吸毒行为，IE在HIV免疫抑制严重的注射吸毒者中更常见。
