Klugman Keith P, Madhi Shabir A, Feldman Charles
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Curr Opin Infect Dis. 2007 Feb;20(1):11-5. doi: 10.1097/QCO.0b013e328012c5f1.
To describe the impact of highly active antiretroviral therapy on the burden of pneumococcal disease and advances in our understanding of the impact of HIV on this disease.
Although highly active antiretroviral therapy has reduced the burden of pneumococcal disease among HIV-infected adults, these infections remain far more common than in HIV uninfected adults. HIV-infected adults who smoke or have comorbidities are at particular risk. In the absence of highly active antiretroviral therapy, pneumococcal meningitis has emerged in Africa as a major disease burden with a high mortality among HIV-infected children and adults. Conjugate pneumococcal vaccine protects HIV-infected infants from pneumococcal pneumonia. In the United States, where conjugate vaccine is given to children, herd immunity has reduced the burden of invasive pneumococcal disease among HIV-infected adults.
The pneumococcus remains a significant cause of morbidity and mortality among HIV-infected children and adults, both in developed and in developing countries.
描述高效抗逆转录病毒疗法对肺炎球菌疾病负担的影响，以及我们对HIV对该疾病影响的认识进展。
尽管高效抗逆转录病毒疗法减轻了HIV感染成人中肺炎球菌疾病的负担，但这些感染在HIV感染成人中仍比未感染成人更为常见。吸烟或患有合并症的HIV感染成人尤其危险。在缺乏高效抗逆转录病毒疗法的情况下，肺炎球菌脑膜炎在非洲已成为一种主要疾病负担，在HIV感染儿童和成人中死亡率很高。结合肺炎球菌疫苗可保护HIV感染婴儿免受肺炎球菌肺炎感染。在美国，儿童接种结合疫苗后，群体免疫减轻了HIV感染成人中侵袭性肺炎球菌疾病的负担。
无论在发达国家还是发展中国家，肺炎球菌仍然是HIV感染儿童和成人发病和死亡的重要原因。
