Pérez-Molina Jose A, Martinez-Perez Angela, Serre Nuria, Treviño Begoña, Ruiz-Giardín José Manuel, Torrús Diego, Goikoetxea Josune, Echevarría Esteban Martín, Malmierca Eduardo, Rojo Gerardo, Calabuig Eva, Gutierrez Belén, Norman Francesca, Lopez-Velez Rogelio
Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain.
Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain.
Enferm Infecc Microbiol Clin. 2016 Feb;34(2):108-13. doi: 10.1016/j.eimc.2015.03.023. Epub 2015 May 26.
The improvement in the prognosis of HIV infection, coupled with the increase in international travel and migration, has led to a rising number of HIV infected travelers. The objective of this study was to describe the epidemiological and clinical features of returning travelers, according to their HIV status.
An observational prospective study was conducted including travelers and immigrants who traveled to visit friends and relatives (VFRs) registered in the +REDIVI collaborative network (January-2009; October-2014). +REDIVI is a national network that registers information regarding infections imported by travelers and immigrants at 21 different centers using a standardized protocol.
A total of 3464 travellers were identified: 72 were HIV+ (2.1%) and 3.392 HIV- (98%). HIV+ vs. HIV- travelers were often older (40.5y vs. 34.2y P=.001), VFRs (79.1% vs. 44.4%; P<.001), and consulted less for pre-travel advice (27% vs. 37%; P=.078). The main destinations for both groups were sub-Saharan Africa and Latin America. The most frequent reasons for consultation after travel were fever, request for a health examination, gastrointestinal complaints, and abnormal laboratory tests (mainly eosinophilia and anemia), which differed between groups. The most frequent diagnoses in HIV+ travelers were malaria (38.8%), newly diagnosed HIV infection (25%), and intestinal parasites (19.4%), while for HIV- travelers the main diagnoses were "healthy" (17.9%), malaria (14%), and intestinal parasites (17.3%).
The typical profile of an HIV+ traveler in +REDIVI was that of a VFR traveler who did not seek pre-travel advice and made high-risk trips. This may increase the chance of acquiring travel-related infections which may pose a special risk for HIV-infected travelers. The post-travel visit was a good opportunity for HIV infection screening.
随着艾滋病毒感染预后的改善,以及国际旅行和移民人数的增加,感染艾滋病毒的旅行者数量不断上升。本研究的目的是根据旅行者的艾滋病毒感染状况,描述回国旅行者的流行病学和临床特征。
开展了一项观察性前瞻性研究,纳入前往探亲访友(VFR)的旅行者和移民,这些人在+REDIVI协作网络中登记(2009年1月至2014年10月)。+REDIVI是一个全国性网络,通过标准化方案在21个不同中心登记旅行者和移民输入性感染的信息。
共识别出3464名旅行者:72名艾滋病毒呈阳性(2.1%),3392名艾滋病毒呈阴性(98%)。艾滋病毒呈阳性与呈阴性的旅行者通常年龄较大(40.5岁对34.2岁;P=0.001),更多是探亲访友者(79.1%对44.4%;P<0.001),且较少咨询旅行前建议(27%对37%;P=0.078)。两组的主要目的地均为撒哈拉以南非洲和拉丁美洲。旅行后咨询的最常见原因是发热、要求进行健康检查、胃肠道不适以及实验室检查异常(主要是嗜酸性粒细胞增多和贫血),两组之间存在差异。艾滋病毒呈阳性的旅行者最常见的诊断是疟疾(38.8%)、新诊断的艾滋病毒感染(25%)和肠道寄生虫感染(19.4%),而艾滋病毒呈阴性的旅行者主要诊断为“健康”(17.9%)、疟疾(14%)和肠道寄生虫感染(17.3%)。
+REDIVI中艾滋病毒呈阳性旅行者的典型特征是不寻求旅行前建议且进行高风险旅行的探亲访友者。这可能增加感染与旅行相关疾病的几率,而这可能对感染艾滋病毒的旅行者构成特殊风险。旅行后就诊是艾滋病毒感染筛查的好机会。