Department of Medicine, Madigan Army Medical Center, Tacoma, Washington, USA
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Infectious Disease Clinical Research Program, Bethesda, Maryland, USA.
J Investig Med. 2021 Aug;69(6):1230-1237. doi: 10.1136/jim-2020-001694. Epub 2021 Apr 23.
The impact of HIV on influenza-like illness (ILI) has been incompletely described in the era of combination antiretroviral therapy, particularly in the post-H1N1 pandemic period. This analysis informs on ILI in an otherwise healthy, predominantly outpatient cohort of adults with HIV in the USA. From September 2010 to March 2015, this multisite observational cohort study enrolled otherwise healthy adults presenting to a participating US military medical center with ILI, a subset of whom were HIV positive. Demographics, clinical data, and self-reported symptom severity were ascertained, and enrollees completed a daily symptom diary for up to 10 days. 510 men were included in the analysis; 50 (9.8%) were HIV positive. Subjects with HIV were older and less likely to be on active duty. Rhinovirus and influenza A were the most commonly identified pathogens. Moderate-severe diarrhea (p<0.001) and fatigue (p=0.01) were more frequently reported by HIV-positive men. HIV positivity was associated with higher gastrointestinal scores, but not other measures of ILI symptom severity, after controlling for age, race, military status, and influenza season. Few were hospitalized. HIV-positive subjects had more influenza B (p=0.04) and were more likely to receive antivirals (32% vs 6%, p<0.01). Antiviral use was not significantly associated with symptom scores when accounting for potential confounders. In this predominantly outpatient cohort of adult men, HIV had minimal impact on ILI symptom severity. Despite similar illness severity, a higher percentage of subjects with HIV reported undergoing antiviral treatment for ILI, likely reflecting differences in prescribing practices.Trial registration number: NCT01021098.
HIV 对类流感疾病（ILI）的影响在联合抗逆转录病毒治疗时代尚未完全描述，尤其是在后 H1N1 大流行时期。本分析报告了美国一个以门诊为主的、以 HIV 感染为主的健康成年人队列中 ILI 的情况。在 2010 年 9 月至 2015 年 3 月期间，这项多中心观察性队列研究纳入了到参与研究的美国军事医疗中心就诊的ILI 健康成年人，其中一部分 HIV 阳性。确定了人口统计学、临床数据和自我报告的症状严重程度，并要求参与者填写每日症状日记，最长可达 10 天。在分析中纳入了 510 名男性；其中 50 名（9.8%）HIV 阳性。HIV 阳性者年龄较大，且更不可能现役。鼻病毒和甲型流感病毒是最常见的病原体。HIV 阳性男性更常报告中度至重度腹泻（p<0.001）和疲劳（p=0.01）。在控制年龄、种族、兵役状态和流感季节后，HIV 阳性与更高的胃肠道评分相关，但与 ILI 症状严重程度的其他指标无关。很少有人住院。HIV 阳性者乙型流感（p=0.04）和更有可能接受抗病毒治疗（32%比 6%，p<0.01）。在考虑潜在混杂因素时，抗病毒治疗与症状评分无显著相关性。在这个以门诊为主的成年男性队列中，HIV 对 ILI 症状严重程度的影响很小。尽管疾病严重程度相似，但更多 HIV 阳性者报告接受了抗病毒治疗，这可能反映了处方实践的差异。试验注册号：NCT01021098。
