Hoepelman A I, van Buren M, van den Broek J, Borleffs J C
Department of Internal Medicine, University of Utrecht, The Netherlands.
AIDS. 1992 Feb;6(2):179-84. doi: 10.1097/00002030-199202000-00006.
Reports from the United States that urinary tract infections (UTI) are more common in homosexual than in heterosexual men have not been confirmed in Europe. The occurrence of several UTI in men infected with HIV-1 has been recorded in The Netherlands. We therefore analysed the relationship between the presence of bacteriuria and the immune status (CD4+ cell count) in these HIV-1-infected patients.
Urinary cultures were obtained prospectively for 2 years, during the first visit and every 6 months thereafter, when signs and symptoms of UTI occurred and when patients had fever of unknown origin. CD4+ cell counts were measured at the same time.
The study was performed at the University Hospital, Utrecht, The Netherlands.
PATIENTS, PARTICIPANTS: One hundred and thirty HIV-1-infected men attended our hospital. Data from 98 were analysed. Eighty-nine (91%) of these men were either homo- or bisexual.
Positive urinary culture.
Group 1 (CD4+ cell count less than 200 x 10(6)/l) consisted of 47 patients; 30% had at least one period of bacteriuria, with 21 episodes. Group 2 (CD4+ cell count 200-500 x 10(6)/l) consisted of 27 patients; 11% had at least one period of bacteriuria, with five episodes. We did not find bacteriuria in the 24 patients in group 3 (CD4+ cell count greater than 500 x 10(6)/l). The rate of bacteriuria per patient-month, 4 (group 1) versus 2 (group 2), differed significantly (P less than 0.001). A significant relationship between CD4+ cell count and bacteriuria was found (P = 0.00003); no relationship, however, was found with anal intercourse, hospitalization, Karnofsky score, follow-up, or age.
We conclude that men infected with HIV and presenting with a CD4+ cell count less than 200 x 10(6)/l are at increased risk for bacteriuria.
美国有报告称，男性同性恋者的尿路感染（UTI）比异性恋男性更为常见，但这一情况在欧洲尚未得到证实。荷兰记录了数例感染HIV-1的男性发生多次UTI的情况。因此，我们分析了这些感染HIV-1的患者中菌尿的存在与免疫状态（CD4+细胞计数）之间的关系。
前瞻性地采集尿培养样本，为期2年，在首次就诊时以及此后每6个月采集一次，当出现UTI的体征和症状时，以及患者出现不明原因发热时采集。同时测量CD4+细胞计数。
该研究在荷兰乌得勒支大学医院进行。
患者、参与者：130名感染HIV-1的男性到我院就诊。对其中98人的数据进行了分析。这些男性中有89人（91%）为同性恋或双性恋。
尿培养阳性。
第1组（CD4+细胞计数低于200×10⁶/l）有47名患者；30%的患者至少有一段菌尿期，共21次发作。第2组（CD4+细胞计数为200 - 500×10⁶/l）有27名患者；11%的患者至少有一段菌尿期，共5次发作。第3组（CD4+细胞计数高于500×10⁶/l）的24名患者未发现菌尿。每组患者每月的菌尿发生率，第1组为4次，第2组为2次，差异有统计学意义（P < 0.001）。发现CD4+细胞计数与菌尿之间存在显著关系（P = 0.00003）；然而，未发现与肛交、住院、卡诺夫斯基评分、随访或年龄有关。
我们得出结论，感染HIV且CD4+细胞计数低于200×10⁶/l的男性菌尿风险增加。
