人类免疫缺陷病毒感染患者的脑膜炎球菌病：对2000 - 2008年美国通过主动监测报告的病例的综述

Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000-2008.

作者信息

Harris Christine M, Wu Henry M, Li Jianmin, Hall H Irene, Lee Adria, Zell Elizabeth, Harrison Lee H, Petit Susan, Farley Monica M, Lynfield Ruth, Miller Lisa, Nichols Megin, Reingold Arthur, Schaffner William, Thomas Ann, MacNeil Jessica R, Clark Thomas A, Cohn Amanda C

机构信息

Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;; Logistics Health Inc., La Crosse, Wisconsin.

Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.

出版信息

Open Forum Infect Dis. 2016 Dec 20;3(4):ofw226. doi: 10.1093/ofid/ofw226. eCollection 2016 Oct.

DOI:10.1093/ofid/ofw226

PMID:28018927

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5170493/

Abstract

BACKGROUND

Although human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear.

METHODS

Expanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites.

RESULTS

Thirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%; = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9-20.9).

CONCLUSIONS

Individuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population.

摘要

背景

虽然人类免疫缺陷病毒（HIV）感染是多种细菌感染的既定危险因素，但HIV感染与脑膜炎球菌病之间的关联仍不明确。

方法

对2000年至2008年期间从美国9个参与基于人群的脑膜炎球菌病主动监测系统的地点报告的患有脑膜炎球菌病和HIV感染的人员进行了扩展病历审查。使用参与地点的国家HIV监测系统的数据，估计了符合疾病控制和预防中心获得性免疫缺陷综合征（AIDS）监测标准的患者中脑膜炎球菌病的发病率。

结果

参与地点报告了33例HIV感染个体的脑膜炎球菌病病例，占所有报告的脑膜炎球菌病病例的2.0%。大多数（75.8%）HIV感染患者为25至64岁的成年男性。在所有25至64岁的脑膜炎球菌病病例中，HIV感染患者和未感染HIV患者的病死率相似（13.3%对10.6%；P = 0.6）。在曾被分类为AIDS的25至64岁HIV感染患者中，脑膜炎球菌病的累积平均发病率为每10万人年3.5例（95%置信区间[CI]，2.1 - 5.6），而未报告患有AIDS的同年龄组人群为每10万人年0.3例（95% CI，0.3 - 0.3）（相对风险 = 12.9；95% CI，7.9 - 20.9）。