Glesby Marshall J, Hoover Donald R, Tan Tianren, Shi Qiuhu, Gao Wei, French Audrey L, Maurer Toby, Young Mary, Dehovitz Jack, Ru Jenny, Anastos Kathryn
Division of International Medicine and Infectious Diseases, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
J Acquir Immune Defic Syndr. 2004 Dec 15;37(5):1604-9. doi: 10.1097/00126334-200412150-00013.
Herpes zoster occurs at all CD4 cell counts in HIV-infected adults. It was hypothesized that even in the era of highly active antiretroviral therapy (HAART), zoster risk is higher in HIV-infected than uninfected women.
Generalized estimating equations modeled self-reported occurrence of zoster between semiannual visits among 1832 HIV-infected and 489 HIV-uninfected women in the Women's Interagency HIV Study followed for up to 7.5 years.
A total of 337 (18.4%) HIV-infected and 7 (1.4%) HIV-uninfected women reported zoster at some time during follow-up. Using HIV-infected women with CD4 >750 cells/microL as the reference category, the odds ratios for reporting zoster since the prior visit were: 1.43 (95% CI 0.86-2.37) for CD4 500-749 cells/microL, 2.07 (95% CI 1.27-3.38) for CD4 350-499 cells/microL, 2.72 (95% CI 1.66-4.46) for CD4 200-349 cells/microL, and 3.16 (95% CI 1.92-5.18) for CD4 <200 cells/microL, compared with 0.11 (95% CI 0.046-0.26) for HIV-uninfected women. In multivariate analyses using visits from all HIV-infected women and only those who initiated HAART, lower CD4 cell count was more strongly associated with zoster incidence than were other clinical indicators.
Herpes zoster is associated with degree of immunosuppression in HIV-infected women, but even women with high CD4 counts are at greater risk of zoster than HIV-uninfected women.
在感染HIV的成年人中，无论CD4细胞计数多少都会发生带状疱疹。据推测，即使在高效抗逆转录病毒治疗（HAART）时代，感染HIV的女性发生带状疱疹的风险也高于未感染HIV的女性。
在女性机构间HIV研究中，对1832名感染HIV的女性和489名未感染HIV的女性进行了长达7.5年的随访，采用广义估计方程对两次半年期访视之间自我报告的带状疱疹发生情况进行建模。
共有337名（18.4%）感染HIV的女性和7名（1.4%）未感染HIV的女性在随访期间的某个时间报告发生了带状疱疹。以CD4>750个细胞/微升的感染HIV的女性为参照组，自上次访视以来报告发生带状疱疹的比值比为：CD4为500 - 749个细胞/微升时为1.43（95%置信区间0.86 - 2.37），CD4为350 - 499个细胞/微升时为2.07（95%置信区间1.27 - 3.38），CD4为200 - 349个细胞/微升时为2.72（95%置信区间1.66 - 4.46），CD4<200个细胞/微升时为3.16（95%置信区间为1.92 - 5.18），而未感染HIV的女性为0.11（95%置信区间0.046 - 0.26）。在对所有感染HIV的女性以及仅对开始接受HAART的女性的访视进行多变量分析时，较低的CD4细胞计数与带状疱疹发病率的关联比其他临床指标更强。
带状疱疹与感染HIV的女性的免疫抑制程度相关，但即使是CD4细胞计数高的女性发生带状疱疹的风险也高于未感染HIV的女性。
