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中非加蓬地区感染人类免疫缺陷病毒(HIV)的成年人中血液丝虫病的流行状况和危险因素:一项试点研究。

Prevalence and risk factors for blood filariasis among HIV-infected adults in Gabon, Central Africa: a pilot study.

机构信息

Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon.

Department of Biology, Faculty of Sciences, Université des Sciences et Techniques de Masuku, BP 901, Franceville, Gabon.

出版信息

Trans R Soc Trop Med Hyg. 2022 Nov 1;116(11):1015-1021. doi: 10.1093/trstmh/trac034.

DOI:10.1093/trstmh/trac034
PMID:35474144
Abstract

BACKGROUND

The level of blood filariasis parasitaemia as well as the frequency of and the relationship between cotrimoxazole prophylaxis (CTX-P), antiretroviral therapy (ART) intake and CD4 cell count among people living with human immunodeficiency virus (PLHIV) in rural areas of Gabon were being studied.

METHODS

Sociodemographic data and recent biological tests of PLHIV and HIV-negative participants were collected. Loa loa and Mansonella perstans microfilaria were detected by direct microscopy examination and leucoconcentration.

RESULTS

Overall, 209 HIV-positive and 148 HIV-negative subjects were enrolled. The overall prevalence of microfilaria was comparable between PLHIV (19.9% [n=41/206]) and HIV-negative participants (14.8% [n=22/148]) (p=0.2). The L. loa infection rate was comparable between HIV-positive (9.2%) and HIV-negative participants (6.8%) (p=0.2), while the M. perstans infection rate was 14-fold higher among PLHIV (p<0.01). L. loa parasitaemia was 6-fold lower in PLHIV receiving CTX-P (median 150 mf/mL [interquartile range {IQR} 125-350]) than in patients without (900 [550-2225]) (p<0.01). Among subjects with a CD4 cell count <200 cells/μL, the prevalence of M. perstans was 7-fold higher than that of L. loa (20.6% vs 2.9%).

CONCLUSIONS

This study suggests a similar exposure to L. loa infection of PLHIV and HIV-negative patients while M. perstans is more frequently found in HIV-positive individuals, notably those with a CD4 count <200 cells/μL.

摘要

背景

在加蓬农村地区,研究了人类免疫缺陷病毒(PLHIV)感染者的血液丝虫寄生血症水平以及复方新诺明预防(CTX-P)、抗逆转录病毒治疗(ART)摄入和 CD4 细胞计数的频率和关系。

方法

收集了 PLHIV 和 HIV 阴性参与者的社会人口统计学数据和最近的生物学检测结果。通过直接显微镜检查和白细胞浓缩检测罗阿罗阿和曼森线虫微丝蚴。

结果

总体而言,纳入了 209 名 HIV 阳性和 148 名 HIV 阴性受试者。PLHIV(41/206,19.9%)和 HIV 阴性参与者(22/148,14.8%)之间微丝蚴的总体流行率无差异(p=0.2)。HIV 阳性者(9.2%)和 HIV 阴性者(6.8%)之间的罗阿罗阿感染率无差异(p=0.2),而 PLHIV 中的曼森线虫感染率高 14 倍(p<0.01)。接受 CTX-P 治疗的 PLHIV(中位数 150 mf/mL [IQR 125-350])的罗阿罗阿寄生虫血症比未接受 CTX-P 治疗的患者低 6 倍(900 [550-2225])(p<0.01)。在 CD4 细胞计数<200 个/μL 的受试者中,曼森线虫的患病率是罗阿罗阿的 7 倍(20.6% vs 2.9%)。

结论

本研究表明,PLHIV 和 HIV 阴性患者对罗阿罗阿感染的暴露相似,而曼森线虫在 HIV 阳性个体中更为常见,尤其是 CD4 细胞计数<200 个/μL 的个体。

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