Laboratório de Pesquisa em Virologia, Universidade Federal da Bahia Hospital, Salvador, Brazil.
J Acquir Immune Defic Syndr. 2011 Aug;57 Suppl 3:S208-11. doi: 10.1097/QAI.0b013e31821e9baf.
Coinfection by HIV-1 and human lymphotropic virus type 1 is a frequent finding in South America, the Caribbean and Africa, and its prevalence varies from 4% to 16% according to the available reports. Although the impact of coinfection on HIV disease is still controversial, there is evidence supporting the contention that it can affect the natural history of both infections. No information is available on coinfection in children. In a nested case-control study, we evaluated 35 coinfected children matched by age, gender, and time of diagnosis to HIV monoinfected control subjects. At the first evaluation, coinfected children were more likely to present any signs and symptoms of disease (P < 0.001) than monoinfected ones despite having significantly higher CD4 cells count (1429 ± 608 vs 928 ± 768 cells/mm; P = 0.003). The proportion of deaths was higher (80%) for coinfected children than for HIV-1-infected ones (20%; relative risk, 2.1; 95% confidence interval, 1.4-3.1; P = 0.01). Survival was also significantly shorter for coinfected children (P = 0.001). Coinfection by HIV-1 and human lymphotropic vírus type 1 in Brazilian children was strongly associated with higher mortality and shorter survival time despite coinfected patients having a higher baseline CD4 cells count.
在南美洲、加勒比海地区和非洲，HIV-1 与人类嗜淋巴细胞病毒 1 共同感染较为常见，根据现有报告，其流行率为 4%至 16%。尽管共同感染对 HIV 疾病的影响仍存在争议，但有证据表明它会影响两种感染的自然病史。目前尚无关于儿童共同感染的数据。在一项巢式病例对照研究中，我们评估了 35 名按年龄、性别和诊断时间与 HIV 单感染对照相匹配的共同感染儿童。在首次评估时，尽管共同感染儿童的 CD4 细胞计数（1429 ± 608 对 928 ± 768 个细胞/mm；P = 0.003）显著较高，但与单感染儿童相比，更有可能出现任何疾病迹象和症状（P < 0.001）。共同感染儿童的死亡率（80%）高于 HIV-1 感染儿童（20%；相对风险，2.1；95%置信区间，1.4-3.1；P = 0.01）。共同感染儿童的生存时间也显著缩短（P = 0.001）。尽管共同感染儿童的基线 CD4 细胞计数较高，但在巴西儿童中，HIV-1 与人类嗜淋巴细胞病毒 1 共同感染与更高的死亡率和更短的生存时间密切相关。
