Hanna D B, Gupta L S, Jones L E, Thompson D M, Kellerman S E, Sackoff J E
Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, New York, NY 10013, USA.
AIDS Care. 2007 Feb;19(2):264-72. doi: 10.1080/09540120600834729.
Despite widespread availability of HAART, opportunistic illnesses (OIs) still occur and result in an increased risk of mortality among persons with AIDS. We estimated the incidence of OIs among all new adult AIDS cases in New York City in 2000 overall and in demographic and clinical subgroups and identified factors associated with occurrence of an AIDS-defining OI versus AIDS diagnosis based on low CD4+ values only. In 2000, 5,451 new AIDS cases were reported to the New York City Department of Health and Mental Hygiene. Of these 27.4% (95% CI: 22.8-32.6) had at least one OI, most frequent being Pneumocystis jiroveci pneumonia (12.2%) and M. tuberculosis (5.3%); 47.1% (41.7-52.5) had a late HIV diagnosis (i.e.< or =6 months before AIDS diagnosis). Persons with a late HIV diagnosis not in recent care had a 3.5-fold increased odds (1.29-9.63) of an OI, compared to non-late testers in care. Other predictors of an OI were injection drug use and older age. We conclude that OIs remain prevalent in the HAART era and late testers not in care are especially likely to develop an OI. Our results support comprehensive HIV programs promoting early HIV testing and linkage to care to prevent OI-related morbidity and mortality.
尽管高效抗逆转录病毒疗法（HAART）已广泛应用，但机会性感染（OIs）仍会发生，并导致艾滋病患者的死亡风险增加。我们估计了2000年纽约市所有新确诊成年艾滋病病例中机会性感染的发生率，总体情况以及在人口统计学和临床亚组中的情况，并确定了与仅基于低CD4 +值定义的艾滋病相关机会性感染发生与艾滋病诊断相关的因素。2000年，纽约市卫生和精神卫生部门报告了5451例新的艾滋病病例。其中，27.4%（95%置信区间：22.8 - 32.6）至少发生过一次机会性感染，最常见的是耶氏肺孢子菌肺炎（12.2%）和结核分枝杆菌感染（5.3%）；47.1%（41.7 - 52.5）的患者确诊HIV较晚（即艾滋病诊断前≤6个月）。与接受治疗的非晚期检测者相比，确诊HIV较晚且未接受近期治疗的患者发生机会性感染的几率增加了3.5倍（1.29 - 9.63）。机会性感染的其他预测因素包括注射吸毒和年龄较大。我们得出结论，在HAART时代，机会性感染仍然普遍存在，未接受治疗的晚期检测者尤其容易发生机会性感染。我们的结果支持全面的HIV项目，促进早期HIV检测并与治疗相联系，以预防与机会性感染相关的发病和死亡。
