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HIV 阳性且 CD4 细胞计数≤200 个/μL 的个体中,复方磺胺甲噁唑所致药物过敏反应的发生率。

Incidence of Allergic Drug Eruption due to Cotrimoxazole in HIV-Positive Individuals with CD4 ≤200 Cells/ul.

机构信息

Department of General Medicine, St. Carolus Hospital, Jakarta, Indonesia.

Department of Dermatovenereology, St. Carolus Hospital, Jakarta, Indonesia.

出版信息

J Int Assoc Provid AIDS Care. 2023 Jan-Dec;22:23259582221146946. doi: 10.1177/23259582221146946.

DOI:10.1177/23259582221146946
PMID:36700255
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9893344/
Abstract

Allergic drug eruptions (ADE) remain a challenge in people living with HIV (PLWH), requiring more studies to guide clinical approaches. While cotrimoxazole is widely used as prophylaxis in PLWH, relationship between client characteristics toward the occurrence of cotrimoxazole ADEs is still poorly understood.A retrospective cohort study followed PLWH initiated with antiretroviral therapy (ART) in St. Carolus Hospital between January 2009 to December 2021. ADE occurrence due to cotrimoxazole were tested for significance using Pearson's Chi-square and Fisher's Exact Test (significant outcome measured as p < 0.05) against CD4 levels at very low (0-100 cells/ul) and low (101-200 cells/ul) groups, comorbidities, and retention status.Cotrimoxazole-related ADEs occurred in 258 (14%) of 1789 subjects with CD4 levels ≤200 cells/ul. Comorbidities of Hepatitis B, Hepatitis C, and M. tuberculosis infections were found in 11, 4, and 95 subjects respectively. 151 (59%) of ADE group had very low CD4 levels (p value0.05). No significant difference was found in ADE incidence between age groups, genders, CD4 levels, comorbidities, and ART retention.Cotrimoxazole-induced ADE is unrelated to CD4 levels, and ART retention was not affected. ADE severity ranges from mild to serious manifestations, and close monitoring is crucial to ensure ADEs are treated ART are well-maintained.

摘要

过敏药物反应(ADE)在 HIV 感染者(PLWH)中仍然是一个挑战,需要更多的研究来指导临床方法。虽然复方新诺明广泛用于 PLWH 的预防,但客户对复方新诺明 ADE 发生的特征之间的关系仍知之甚少。

一项回顾性队列研究对 2009 年 1 月至 2021 年 12 月期间在圣卡罗勒斯医院接受抗逆转录病毒治疗(ART)的 PLWH 进行了研究。使用 Pearson's Chi-square 和 Fisher's Exact Test(显著结果测量为 p<0.05)对因复方新诺明引起的 ADE 与非常低(0-100 个细胞/ul)和低(101-200 个细胞/ul)组、合并症和保留状态的 CD4 水平进行了测试。

在 1789 名 CD4 水平≤200 个细胞/ul 的患者中,有 258 名(14%)发生了与复方新诺明相关的 ADE。分别有 11、4 和 95 名患者患有乙型肝炎、丙型肝炎和结核分枝杆菌感染的合并症。在 ADE 组中,有 151 名(59%)患者的 CD4 水平非常低(p 值<0.05)。在 ADE 发生率方面,年龄组、性别、CD4 水平、合并症和 ART 保留率之间没有发现显著差异。

复方新诺明诱导的 ADE 与 CD4 水平无关,ART 保留率不受影响。ADE 的严重程度从轻度到严重表现不等,密切监测对于确保 ADE 得到治疗和 ART 得到良好维持至关重要。