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全球HIV感染成人中血小板减少症的患病率:一项系统评价和荟萃分析。

The global prevalence of thrombocytopenia among HIV-infected adults: A systematic review and meta-analysis.

作者信息

Getawa Solomon, Aynalem Melak, Bayleyegn Biruk, Adane Tiruneh

机构信息

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Int J Infect Dis. 2021 Apr;105:495-504. doi: 10.1016/j.ijid.2021.02.118. Epub 2021 Mar 5.

Abstract

BACKGROUND

Thrombocytopenia is the second most frequent complication of human immunodeficiency virus (HIV) infection, occurring in about 4-40% of HIV-infected patients. This study aimed to determine the global prevalence of thrombocytopenia among HIV/AIDS adults and its association with highly active antiretroviral therapy (HAART).

METHOD

This systematic review and meta-analysis was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Joana Brigg's Institute (JBI) critical appraisal checklist was used for quality appraisal of the included articles. A random-effect model was fitted to calculate the pooled estimates using STATA version-11. A sub-group analysis and sensitivity analysis were carried out to determine the potential source of heterogeneity.

RESULT

Of the 1823 articles that were retrieved, 20 full-text articles were eligible for meta-analysis. The overall pooled prevalence of thrombocytopenia among HIV-infected adults was 17.9% (95% CI: 14.69, 21.12) I = 96.4%. The pooled prevalence of thrombocytopenia was 21.00% (95% CI: 17.35, 24.65) and 11.64% (95% CI: 6.66, 16.62), before and after initiation of HAART, respectively.

CONCLUSION

Thrombocytopenia is a common comorbidity in HIV patients and HAART was significantly associated with reduced thrombocytopenia. Therefore, prompt start of HAART might help to decrease the prevalence of thrombocytopenia and its subsequent complications.

摘要

背景

血小板减少是人类免疫缺陷病毒(HIV)感染的第二常见并发症,约4 - 40%的HIV感染患者会出现。本研究旨在确定HIV/AIDS成年患者中血小板减少的全球患病率及其与高效抗逆转录病毒治疗(HAART)的关联。

方法

本系统评价和荟萃分析是根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行的。使用乔安娜·布里格斯研究所(JBI)的批判性评价清单对纳入的文章进行质量评估。使用STATA 11版拟合随机效应模型来计算合并估计值。进行亚组分析和敏感性分析以确定异质性的潜在来源。

结果

在检索到的1823篇文章中,有20篇全文文章符合荟萃分析的条件。HIV感染成年患者中血小板减少的总体合并患病率为17.9%(95%置信区间:14.69, 21.12),I = 96.4%。开始HAART之前和之后,血小板减少的合并患病率分别为21.00%(95%置信区间:17.35, 24.65)和11.64%(95%置信区间:6.66, 16.62)。

结论

血小板减少是HIV患者常见的合并症,HAART与血小板减少的减少显著相关。因此,及时开始HAART可能有助于降低血小板减少及其后续并发症的患病率。

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