Riebold D, Enoh D O, Kinge T N, Akam W, Bumah M K, Russow K, Klammt S, Loebermann M, Fritzsche C, Eyong J E, Eppel G, Kundt G, Hemmer C J, Reisinger E C
Division of Tropical Medicine and Infectious Diseases, University of Rostock Medical School, Rostock, Germany.
Regional Hospital Limbe, Limbe, Cameroon.
Trop Med Int Health. 2014 Jun;19(6):643-655. doi: 10.1111/tmi.12299. Epub 2014 Mar 19.
To determine the prevalence of Pneumocystis pneumonia (PCP), a major opportunistic infection in AIDS patients in Europe and the USA, in Cameroon.
Induced sputum samples from 237 patients without pulmonary symptoms (126 HIV-positive and 111 HIV-negative outpatients) treated at a regional hospital in Cameroon were examined for the prevalence of Pneumocystis jirovecii by specific nested polymerase chain reaction (nPCR) and staining methods. CD counts and the history of antiretroviral therapy of the subjects were obtained through the ESOPE database system.
Seventy-five of 237 study participants (31.6%) were colonised with Pneumocystis, but none showed active PCP. The Pneumocystis colonisation rate in HIV-positive subjects was more than double that of HIV-negative subjects (42.9% vs. 18.9%, P < 0.001). In the HIV-positive group, the colonisation rate corresponds to the reduction in the CD lymphocyte counts. Subjects with CD counts >500 cells/μl were colonised at a rate of 20.0%, subjects with CD counts between 200 and 500 cells/μl of 42.5%, and subjects with CD counts <200 cells/μl of 57.1%. Colonisation with Pneumocystis in Cameroon seems to be comparable to rates found in Western Europe. Prophylactic and therapeutic measures against Pneumocystis should be taken into account in HIV care in western Africa.
确定卡氏肺孢子虫肺炎（PCP）在喀麦隆的流行情况，PCP是欧美艾滋病患者的一种主要机会性感染。
在喀麦隆一家地区医院对237例无肺部症状的患者（126例HIV阳性和111例HIV阴性门诊患者）的诱导痰样本，采用特异性巢式聚合酶链反应（nPCR）和染色方法检测耶氏肺孢子菌的流行情况。通过ESOPE数据库系统获取受试者的CD计数和抗逆转录病毒治疗史。
237名研究参与者中有75名（31.6%）被肺孢子虫定植，但均未出现活动性PCP。HIV阳性受试者的肺孢子虫定植率是HIV阴性受试者的两倍多（42.9%对18.9%，P<0.001）。在HIV阳性组中，定植率与CD淋巴细胞计数的降低相对应。CD计数>500个细胞/μl的受试者定植率为20.0%，CD计数在200至500个细胞/μl之间的受试者为42.5%，CD计数<200个细胞/μl的受试者为57.1%。喀麦隆的肺孢子虫定植情况似乎与西欧的发现率相当。在西非的HIV护理中应考虑针对肺孢子虫的预防和治疗措施。
