Faculty of Medicine and Health Science, University of Health Sciences - Infectious Diseases and Tropical Medicine, Libreville, Gabon; Union's Office in Myanmar - Infectious Diseases, Naypyidaw, Myanmar; Centre Hospitalier de Denain, Service des Maladies Infectieuses et Tropicales, 25 bis rue Jean Jaurès, 59723, Denain cedex, France.
Am J Trop Med Hyg. 2014 Feb;90(2):211-5. doi: 10.4269/ajtmh.12-0780. Epub 2013 Dec 9.
Opportunistic diseases cause substantial morbidity and mortality to human immunodeficiency virus (HIV)-infected patients. Highly active antiretroviral therapy (HAART) leading to immune reconstitution is the most effective treatment of preventing opportunistic diseases. This retrospective study established an epidemiologic profile of opportunistic diseases 10 years after the introduction of HAART. The HIV antiretroviral therapy-naive patients matching inclusion criteria were included. The primary outcome was the prevalence of opportunistic diseases. From January 1, 2002 to September 30, 2010, 654 opportunistic diseases were identified in 458 patients. Pulmonary tuberculosis, herpes zoster, cerebral toxoplasmosis, oral candidiasis, and severe pneumonia accounted for 22.05%, 15.94%, 14.19%, 14.19%, and 9.39%, respectively. Cryptococcal meningitis and pneumocystosis accounted for 0.44% and 0.21%, respectively. The prevalence of opportunistic diseases in Gabon remains high. New guidelines emphasize the importance of initiating antiretroviral therapy early to reconstitute the immune system, and reduce disease risk, and treat the primary opportunistic infection of pulmonary tuberculosis.
机会性疾病会给感染人类免疫缺陷病毒（HIV）的患者带来严重的发病率和死亡率。高效抗逆转录病毒治疗（HAART）可重建免疫，是预防机会性疾病最有效的治疗方法。本回顾性研究建立了 HAART 引入 10 年后机会性疾病的流行病学特征。符合纳入标准的 HIV 初治患者被纳入研究。主要结局是机会性疾病的患病率。2002 年 1 月 1 日至 2010 年 9 月 30 日，458 例患者中确诊了 654 例机会性疾病。肺结核、带状疱疹、脑弓形虫病、口腔念珠菌病和重症肺炎分别占 22.05%、15.94%、14.19%、14.19%和 9.39%。隐球菌性脑膜炎和肺孢子菌肺炎分别占 0.44%和 0.21%。加蓬的机会性疾病患病率仍然很高。新指南强调了早期启动抗逆转录病毒治疗以重建免疫系统、降低疾病风险和治疗肺结核这一主要机会性感染的重要性。
