Tindall B, Sharkey T, Kaldor J, Cooper D A
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, Australia.
Aust N Z J Med. 1992 Aug;22(4):369-73. doi: 10.1111/j.1445-5994.1992.tb02150.x.
We sought to evaluate the potential impact of a proposed revision in the case definition of acquired immunodeficiency syndrome (AIDS) (from a clinical case definition to one also including subjects with HIV infection who have an absolute number of peripheral CD4+ cells of less than 200 x 10(6)/L) among 512 HIV-seropositive homosexual/bisexual who were reviewed between 1984 and 1991. According to the current case definition, 151 (30%) of 512 at-risk subjects developed AIDS between 1984 and August 1, 1991. Of the 361 at-risk subjects who were not classified as AIDS by the current definition, 47 (13%; 95% CI 9-17%) were classified as AIDS according to the revised definition. The median time to development of AIDS according to the revised definition was 288 weeks and that according to the current definition was 338 weeks. Data on clinical status were available for 34 of the new cases at the time of their diagnosis according to the proposed case definition: 16 (47%) of these were asymptomatic, 10 (29%) had persistent generalised lymphadenopathy and eight had minor infectious diseases. Of the 151 cases diagnosed according to the current definition, 78 (52%) had an antecedent CD4+ cell count that met the criteria for AIDS under the revised definition a median of 59 weeks before their diagnosis according to the current definition. These data indicate an appreciable increase in the number of cases of AIDS in this cohort when the revised case definition was applied. These findings have important implications for the surveillance, and for the clinical monitoring and treatment, of patients with HIV disease in Australia.
我们试图评估在1984年至1991年间接受检查的512名艾滋病毒血清阳性同性恋/双性恋者中，拟议的获得性免疫缺陷综合征（艾滋病）病例定义修订（从临床病例定义修订为还包括外周血CD4 +细胞绝对计数低于200×10⁶/L的艾滋病毒感染者）的潜在影响。根据当前病例定义，在1984年至1991年8月1日期间，512名高危受试者中有151人（30%）患上了艾滋病。在目前定义未归类为艾滋病的361名高危受试者中，根据修订后的定义，有47人（13%；95%置信区间9 - 17%）被归类为艾滋病。根据修订后的定义，发展为艾滋病的中位时间为288周，而根据当前定义为338周。根据拟议病例定义，在34例新病例诊断时可获得临床状态数据：其中16例（47%）无症状，10例（29%）有持续性全身性淋巴结肿大，8例有轻度传染病。在根据当前定义诊断的151例病例中，78例（52%）在根据当前定义诊断前中位数59周时的既往CD4 +细胞计数符合修订后定义下的艾滋病标准。这些数据表明，应用修订后的病例定义时，该队列中艾滋病病例数有明显增加。这些发现对澳大利亚艾滋病毒疾病患者的监测、临床监测和治疗具有重要意义。
