Farizo K M, Buehler J W, Chamberland M E, Whyte B M, Froelicher E S, Hopkins S G, Reed C M, Mokotoff E D, Cohn D L, Troxler S
Division of HIV/AIDS, Disease Control, Atlanta, Ga 30333.
JAMA. 1992 Apr 1;267(13):1798-805.
To describe the spectrum of disease in persons with human immunodeficiency virus (HIV) infection.
Retrospective survey of medical records.
More than 50 clinics, hospitals, and private medical practices in nine US cities.
A total of 626 women and 7008 men 13 years of age or older with HIV infection who received medical care from January 1990 through March 1991 were consecutively enrolled.
Any history of diseases in the 1987 case definition for the acquired immunodeficiency syndrome (AIDS), and during the 12-month period preceding enrollment (baseline period), the occurrence of other major diseases, hospitalizations, and results of CD4+ lymphocyte counts.
Thirty-two percent of persons met the 1987 case definition for AIDS. The occurrence of an AIDS-indicator disease during the baseline period ranged from 3% (33/1011) to 46% (1254/2748) among persons with CD4+ lymphocyte counts of 0.50 x 10(9)/L or greater and fewer than 0.20 x 10(9)/L (greater than or equal to 500 and less than 200 CD4+ lymphocytes per microliter), respectively, and, at comparable CD4+ lymphocyte levels, was similar among women compared with men, and among persons who reported intravenous drug use compared with men who reported male-to-male sex. The frequency of one or more other major infectious diseases (eg, other pneumonias, bacterial sepsis, pulmonary tuberculosis) ranged from 6% to 16% among persons with CD4+ lymphocyte counts of 0.50 x 10(9)/L or greater and fewer than 0.20 x 10(9)/L, respectively; these illnesses were also associated with a history of intravenous drug use. Among persons who did not meet the 1987 AIDS case definition, 30% of those with an available CD4+ lymphocyte count had fewer CD4+ cells than 0.20 x 10(9)/L, 8% had one or more major infectious diseases, and 14% had one or more hospital admissions.
For every person with AIDS at these sites, two additional persons with HIV infection were receiving medical care, many of whom had severe immunosuppression and a broad spectrum of serious HIV-related disease.
描述人类免疫缺陷病毒（HIV）感染者的疾病谱。
对病历进行回顾性调查。
美国9个城市的50多家诊所、医院和私人医疗诊所。
连续纳入了1990年1月至1991年3月期间接受医疗护理的626名13岁及以上的HIV感染女性和7008名男性。
1987年获得性免疫缺陷综合征（AIDS）病例定义中的任何疾病史，以及在入组前12个月期间（基线期）其他主要疾病的发生情况、住院情况和CD4+淋巴细胞计数结果。
32%的人符合1987年AIDS病例定义。在基线期，CD4+淋巴细胞计数分别为0.50×10⁹/L或更高以及低于0.20×10⁹/L（每微升分别大于或等于500个和少于200个CD4+淋巴细胞）的人群中，AIDS指示疾病的发生率分别为3%（33/1011）至46%（1254/2748）；在可比的CD4+淋巴细胞水平下，女性与男性相比，以及报告静脉吸毒的人与报告男男性行为的男性相比，情况相似。在CD4+淋巴细胞计数分别为0.50×10⁹/L或更高以及低于0.20×10⁹/L的人群中，一种或多种其他主要传染病（如其他肺炎、细菌性败血症、肺结核）的发生率分别为6%至16%；这些疾病也与静脉吸毒史有关。在不符合1987年AIDS病例定义的人群中，30%的CD4+淋巴细胞计数可用者的CD4+细胞少于0.20×10⁹/L，8%的人有一种或多种主要传染病，14%的人有一次或多次住院治疗。
在这些地点，每有一名AIDS患者，就有另外两名HIV感染者正在接受医疗护理，其中许多人有严重的免疫抑制和一系列严重的HIV相关疾病。
