1995年至1998年巴西圣保罗HIV-1感染患者中的分枝杆菌血症
Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998.
作者信息
Hadad D J, Palaci M, Pignatari A C C, Lewi D S, Machado M A S, Telles M A S, Martins M C, Ueki S Y M, Vasconcelos G M, Palhares M C A
机构信息
Núcleo de Doenças Infecciosas, Centro Biomédico/Espírito Santo Federal University, Vitória (ES), Brasil.
出版信息
Epidemiol Infect. 2004 Jan;132(1):151-5. doi: 10.1017/s0950268803001535.
From July 1995 to August 1998, mycobacterial blood cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referência e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referência de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at HSP, and 18 (10.1%) at CRAS. The frequency of positive cultures declined sharply from 22.6% in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active antiretroviral therapy. In 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.
1995年7月至1998年8月期间，从圣保罗医院艾滋病参考与培训中心（CRTA）、圣保罗医院（HSP）和桑托斯艾滋病参考中心（CRAS）的1032例HIV感染患者中获取了分枝杆菌血培养样本。总体而言，共检测到179例分枝杆菌血症发作：CRTA有111例（62.0%），HSP有50例（27.9%），CRAS有18例（10.1%）。阳性培养的频率从1995年的22.6%急剧下降至1998年的6.9%，这与公共资助的高效抗逆转录病毒疗法分发后机会性感染的减少相一致。1995年，分枝杆菌血症更常见于鸟分枝杆菌复合群（59.2%）而非结核分枝杆菌（28.6%），而在1998年，相对频率发生了逆转（分别为28.6%和64.3%），这可能是由于结核分枝杆菌的毒力增加以及包括未意识到自己感染HIV的患者在内的免疫功能较低患者发生侵袭性感染的风险更高所致。
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