Shalaka N S, Garred N A, Zeglam H T, Awasi S A, Abukathir L A, Altagdi M E, Rayes A A
Department of Infectious Diseases, Tripoli Medical Centre, Ain Zara, Tripoli, Libya; Department of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya.
Department of Infectious Diseases, Tripoli Medical Centre, Ain Zara, Tripoli, Libya.
East Mediterr Health J. 2015 Oct 2;21(9):635-46. doi: 10.26719/2015.21.9.635.
In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.
在利比亚,人们对与艾滋病病毒相关的住院治疗情况及住院死亡率知之甚少。这是一项对的黎波里医疗中心2013年与艾滋病病毒相关住院病例的回顾性分析。在分析的227例病例中,82.4%为男性,他们的年龄显著更大(40.0岁对36.5岁),报告有注射吸毒史(58.3%对0%),且与女性相比丙型肝炎病毒合并感染率更高(65.8%对0%)。严重免疫抑制很普遍(CD4细胞计数中位数 = 42个/微升)。念珠菌病是最常见的诊断疾病(26.0%);肺孢子菌肺炎是最常见的呼吸道疾病(8.8%),而8.4%的患者被诊断为脑弓形虫病。当前使用高效抗逆转录病毒疗法与较低的住院死亡率风险独立相关(比值比为0.33),而中枢神经系统症状(比值比为4.12)、败血症(比值比为6.98)和总淋巴细胞计数低(比值比为3.60)与风险增加相关。在本研究中,出现严重免疫抑制的晚期就诊情况很常见,且与显著的住院死亡率相关。