Keusch G T, Thea D M, Kamenga M, Kakanda K, Mbala M, Brown C, Davachi F
ICAR Unit, Mama Yemo Hospital, Kinshasa, Zaire.
Acta Paediatr Suppl. 1992 Sep;381:45-8. doi: 10.1111/j.1651-2227.1992.tb12371.x.
Chronic diarrhea and wasting are very common manifestations of AIDS in adults in developing countries. Etiologic studies show that protozoa (including Cryptosporidium parvum, Isospora belli, and Enterocytozoon bieniusi) and Mycobacterium avium-intracellulara are the most frequently identified pathogens. Limited data in children suggest that common enteric pathogens are equally as likely in HIV+ and HIV- babies. Preliminary analysis of an ongoing longitudinal study of 469 babies born to mothers with known HIV serostatus in Kinshasa, Zaire, reveals progression of acute to persistent diarrhea is six times greater in HIV+ compared to HIV- babies, and 3.5 times greater in HIV- babies born of HIV+ mothers in comparison to HIV- babies with HIV- mothers. HIV+ babies were also at greater risk than HIV- babies to have recurrent episodes of diarrhea (RR = 2.3). Fifty percent of the deaths were due to acute or persistent diarrhea, and were strongly associated with HIV infection. Efforts to improve child survival in AIDS infected populations will need to address HIV infections in both mothers and infants.
在发展中国家，慢性腹泻和消瘦是成人艾滋病非常常见的表现。病因学研究表明，原生动物（包括微小隐孢子虫、贝氏等孢球虫和比氏肠胞微孢子虫）和鸟分枝杆菌复合群是最常鉴定出的病原体。儿童方面的有限数据表明，常见肠道病原体在感染HIV的婴儿和未感染HIV的婴儿中出现的可能性相同。对扎伊尔金沙萨469名母亲HIV血清学状态已知的婴儿进行的一项正在进行的纵向研究的初步分析显示，与未感染HIV的婴儿相比，感染HIV的婴儿从急性腹泻发展为持续性腹泻的几率高6倍，与母亲未感染HIV的未感染HIV的婴儿相比，母亲感染HIV的未感染HIV的婴儿出现这种情况的几率高3.5倍。感染HIV的婴儿出现腹泻复发的风险也高于未感染HIV的婴儿（相对危险度=2.3）。50%的死亡是由急性或持续性腹泻导致的，并且与HIV感染密切相关。在受艾滋病感染的人群中，为提高儿童存活率所做的努力需要同时解决母亲和婴儿的HIV感染问题。
