Emergency Department, General University Hospital of Alicante-ISABIAL, Alicante, Spain.
CIO Research Institute, Miguel Hernandez University of Elche, Alicante, Spain.
Parasitol Res. 2021 Feb;120(2):755-761. doi: 10.1007/s00436-020-07007-5. Epub 2021 Jan 14.
Toxoplasma gondii infection was one of the most frequent AIDS-defining conditions in HIV-infected individuals until the advent of combination antiretroviral therapy. We aimed to assess the clinical load, coinfection, and mortality, as well as time trends for people living with HIV and hospitalized with Toxoplasma gondii infection, in Spain from 1997 to 2015. Retrospective observational analysis using the Spanish National Registry of Hospital Discharges. Information was retrieved for the study period using the International Classification of Diseases, 9th revision. There were 66,451,094 hospital admissions in Spain from 1997 to 2015, including 472,269 (0.71%) in people living with HIV. Toxoplasma gondii infection was registered in 9006 of these (overall prevalence 1.91%), making it the fifth most common opportunistic infection in hospitalized HIV-positive patients. Prevalence of Toxoplasma gondii infection declined in this group from 4.2% in 1997 to 0.8% in 2015 (p < 0.001), while mean age increased, from 35 years in 1997 to 44 years in 2015. The overall in-hospital mortality rate declined from 13.5% in 1997 to 8.9% in 2015, and it was higher in the concomitant presence of bacterial pneumonia (28.9% vs. 10.2%, p < 0.001), cryptosporidiosis (26.9% vs. 11.5%; p = 0.03), cytomegalovirus disease (18.2% vs. 11.2%, p < 0.001), Pneumocystis jiroveci pneumonia (31.5% vs. 10.5%, p < 0.001), leukoencephalopathy (19.8% vs. 11.78% p < 0.001), and wasting syndrome (29.3% vs 10.9%; p < 0.001). Toxoplasma gondii infection prevalence has significantly declined among hospitalized HIV-infected patients in Spain during the last two decades, coinciding with the widespread use of combination antiretroviral therapy.
弓形虫感染是艾滋病定义条件中 HIV 感染者最常见的条件之一，直到联合抗逆转录病毒治疗出现。我们旨在评估 1997 年至 2015 年期间在西班牙，因感染弓形体病而住院的 HIV 感染者的临床负担、合并感染和死亡率以及时间趋势。使用西班牙国家住院记录进行回顾性观察分析。使用 9 次国际疾病分类检索研究期间的信息。1997 年至 2015 年，西班牙有 66451094 例住院治疗，其中 472269 例（0.71%）为 HIV 感染者。在这些人中，有 9006 例（总体患病率 1.91%）记录了弓形体病感染，这是住院 HIV 阳性患者中第五大常见机会性感染。该组中弓形体病感染的患病率从 1997 年的 4.2%下降到 2015 年的 0.8%（p<0.001），而平均年龄从 1997 年的 35 岁增加到 2015 年的 44 岁。总体住院死亡率从 1997 年的 13.5%下降到 2015 年的 8.9%，在伴有细菌性肺炎（28.9%比 10.2%，p<0.001）、隐孢子虫病（26.9%比 11.5%；p=0.03）、巨细胞病毒病（18.2%比 11.2%，p<0.001）、肺孢子菌肺炎（31.5%比 10.5%，p<0.001）、脑白质病（19.8%比 11.78%，p<0.001）和消瘦综合征（29.3%比 10.9%，p<0.001）时更高。在过去的二十年中，西班牙因感染弓形体病而住院的 HIV 感染者中，该疾病的患病率显著下降，这与联合抗逆转录病毒治疗的广泛应用相一致。
