Holman R C, Janssen R S, Buehler J W, Zelasky M T, Hooper W C
Division of Immunologic Disease, Centers for Disease Control, Atlanta, GA 30333.
Neurology. 1991 Nov;41(11):1733-6. doi: 10.1212/wnl.41.11.1733.
We analyzed progressive multifocal leukoencephalopathy (PML) mortality data from 1979 to 1987 and data on persons with acquired immunodeficiency syndrome (AIDS) reported to the Centers for Disease Control (CDC). Based on analyses of multiple-cause-of-death vital statistics, deaths related to PML have increased fourfold from 1.5/10,000,000 persons in 1979 to 6.1/10,000,000 persons in 1987. The increase in the PML annual death rate began in 1984, occurred primarily in men 20 to 49 years of age, and was greatest in states known to have a high incidence of AIDS. In 1987, 56% of death certificates that listed PML as a cause of death also listed human immunodeficiency virus (HIV) infection. Analysis of AIDS case reports to the CDC from 1981 through June 1990 demonstrated that 0.72% of persons with AIDS were reported as having PML. Although most persons with AIDS who had PML were 20 to 49 years of age (84.6%), PML was reported more frequently among persons with AIDS greater than or equal to 50 years old than less than 50 years old. In addition, PML was reported more frequently among persons with AIDS who were exposed to HIV by blood transfusion than those in all other exposure categories. These data demonstrate that the increase in PML mortality from 1979 to 1987 was associated with the large increase in immunosuppressed persons with AIDS.
我们分析了1979年至1987年进行性多灶性白质脑病（PML）的死亡率数据以及向疾病控制中心（CDC）报告的获得性免疫缺陷综合征（AIDS）患者的数据。基于对多死因生命统计数据的分析，与PML相关的死亡人数已增加了四倍，从1979年的每1000万人中有1.5例增至1987年的每1000万人中有6.1例。PML年死亡率的增加始于1984年，主要发生在20至49岁的男性中，在已知AIDS发病率高的州最为明显。1987年，在将PML列为死因的死亡证明中，有56%也列出了人类免疫缺陷病毒（HIV）感染。对1981年至1990年6月向CDC报告的AIDS病例报告进行分析表明，0.72%的AIDS患者被报告患有PML。尽管大多数患有PML的AIDS患者年龄在20至49岁之间（84.6%），但在年龄大于或等于50岁的AIDS患者中，PML的报告频率高于年龄小于50岁的患者。此外，与通过输血接触HIV的AIDS患者相比，在所有其他接触类别中的患者中，PML的报告频率更高。这些数据表明，1979年至1987年PML死亡率的增加与免疫抑制的AIDS患者数量的大幅增加有关。
