Farber B F, Lesser M, Kaplan M H, Woltmann J, Napolitano B, Armellino D
Department of Medicine, North Shore University Hospital, Manhasset, New York 11030.
Infect Control Hosp Epidemiol. 1991 Jul;12(7):429-34. doi: 10.1086/646373.
To determine the incidence of infection in human immunodeficiency virus (HIV)-infected patients during periods of neutropenia and non-neutropenia. To compare the infection rates in patients with HIV disease to those in a group hospitalized with neutropenia and hematologic malignancy.
Prospective observational study conducted between December 1985 and December 1987 at a university teaching hospital. Thirty patients with documented acquired immunodeficiency syndrome (AIDS) and absolute T-helper cells less than 200 mm/mm3. All patients had a period of non-neutropenia following a neutropenic period (neutrophils less than 1000 cells/mm3).
The rate of first infection during neutropenic and non-neutropenic periods for opportunistic infection and nonopportunistic infections were compared. There were no differences between infection rates for the two time periods for both types of infections. A subgroup of patient care days in which non-neutropenic days followed neutropenic days also was studied to eliminate selection bias. In this group, a comparison of infection rates also revealed no difference between neutropenic and non-neutropenic periods. An alternate analysis of the time until first infection during periods of neutropenia or non-neutropenia was done using the Kaplan-Meier product limit method. There was a longer infection-free period for the neutropenic group for opportunistic infections, but it was not statistically significant (p less than .1). In addition, we compared HIV-infected patients with a group of 37 patients with neutropenia from hematologic malignancy. There was a significantly higher rate of all infections, particularly bacteremias (p less than .001), in the group of patients with hematologic malignancies when compared with all subsets of patients with HIV disease.
We conclude that patients with HIV disease and modest neutropenia do not have an increased risk of bacterial infection. The incidence of all infections is significantly greater in patients with neutropenia secondary to hematologic malignancy.
确定人类免疫缺陷病毒（HIV）感染患者在中性粒细胞减少期和非中性粒细胞减少期的感染发生率。比较HIV疾病患者与因中性粒细胞减少和血液系统恶性肿瘤住院的一组患者的感染率。
1985年12月至1987年12月在一家大学教学医院进行的前瞻性观察性研究。30例有记录的获得性免疫缺陷综合征（AIDS）患者，绝对T辅助细胞少于200/mm³。所有患者在中性粒细胞减少期（中性粒细胞少于1000/mm³）后均有一段非中性粒细胞减少期。
比较了中性粒细胞减少期和非中性粒细胞减少期机会性感染和非机会性感染的首次感染率。两种类型感染在两个时间段的感染率无差异。还研究了中性粒细胞减少日后接着是非中性粒细胞减少日的患者护理日亚组，以消除选择偏倚。在该组中，感染率比较也显示中性粒细胞减少期和非中性粒细胞减少期无差异。使用Kaplan-Meier乘积限法对中性粒细胞减少期或非中性粒细胞减少期至首次感染的时间进行了另一种分析。中性粒细胞减少组机会性感染的无感染期较长，但无统计学意义（p<0.1）。此外，我们将HIV感染患者与37例血液系统恶性肿瘤所致中性粒细胞减少患者进行了比较。与HIV疾病患者的所有亚组相比，血液系统恶性肿瘤患者组的所有感染发生率，尤其是菌血症发生率显著更高（p<0.001）。
我们得出结论，HIV疾病和轻度中性粒细胞减少患者发生细菌感染的风险没有增加。继发于血液系统恶性肿瘤的中性粒细胞减少患者所有感染的发生率显著更高。
