Huson Michaëla A M, Kalkman Rachel, Stolp Sebastiaan M, Janssen Saskia, Alabi Abraham S, Beyeme Justin O, van der Poll Tom, Grobusch Martin P
Division of Infectious Diseases, Center of Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-105, 1105 AZ, Amsterdam, The Netherlands,
Infection. 2015 Aug;43(4):443-51. doi: 10.1007/s15010-015-0753-2. Epub 2015 Mar 11.
HIV, bacterial sepsis, malaria, and tuberculosis are important causes of disease in Africa. We aimed to determine the impact of HIV on the presentation, causes and outcome of bacterial sepsis and other acute febrile illnesses in Gabon, Central Africa.
We performed a prospective observational study in new adult admissions with fever or hypothermia (≥ 38 or <36 °C). Blood cultures, as well as HIV and malaria testing were performed in all patients.
We enrolled 382 patients, including 77 (20.2%) with HIV infection. Malaria was the most frequent diagnosis (n = 130, 34%), and was associated with a more severe presentation in HIV patients. Sepsis was also common (n = 107, 28%), including 29 (7.6%) patients with culture confirmed bacterial bloodstream infection. Bacterial bloodstream infections were more frequent in HIV patients, in particular with S. pneumoniae. Tuberculosis was observed in 29 (7.6%) patients, and was also more common in HIV patients. The majority of HIV patients was newly diagnosed, and only 15 (19.5%) were using combination antiretroviral therapy.
Our findings illustrate the impact of HIV co-infection on the burden of sepsis, malaria and tuberculosis in Gabon, as well as the need to scale up HIV counseling, testing and treatment.
艾滋病毒、细菌性败血症、疟疾和结核病是非洲重要的疾病病因。我们旨在确定艾滋病毒对中非加蓬细菌性败血症及其他急性发热性疾病的表现、病因和结局的影响。
我们对新入院的发热或体温过低（≥38或<36°C）的成年患者进行了一项前瞻性观察研究。对所有患者进行了血培养以及艾滋病毒和疟疾检测。
我们纳入了382例患者，其中77例（20.2%）感染了艾滋病毒。疟疾是最常见的诊断（n = 130，34%），并且与艾滋病毒患者中更严重的表现相关。败血症也很常见（n = 107，28%），包括29例（7.6%）血培养确诊为细菌性血流感染的患者。细菌性血流感染在艾滋病毒患者中更常见，尤其是肺炎链球菌感染。29例（7.6%）患者观察到结核病，在艾滋病毒患者中也更常见。大多数艾滋病毒患者是新诊断出的，只有15例（19.5%）正在使用抗逆转录病毒联合疗法。
我们的研究结果说明了艾滋病毒合并感染对加蓬败血症、疟疾和结核病负担的影响，以及扩大艾滋病毒咨询、检测和治疗的必要性。
