Diana Nina E, Feldman Charles
Division of Nephrology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
South Afr J HIV Med. 2019 Aug 13;20(1):877. doi: 10.4102/sajhivmed.v20i1.877. eCollection 2019.
Although measles is traditionally a childhood illness, there are an increasing number of adult cases. Despite both measles and HIV infection being endemic in sub-Saharan Africa, there are little data regarding outcomes in co-infected patients.
Compare demographic, clinical, laboratory and radiographic features, as well as outcome (length of hospital stay, complications and mortality) between HIV-infected and HIV-uninfected adult patients admitted with confirmed measles.
We conducted a retrospective record review of adult patients with confirmed measles who were admitted to the Infectious Diseases Unit at the Charlotte Maxeke Johannesburg Academic Hospital during the peak of the 2009 and 2010 South African measles outbreak. The data collected included demographic, clinical and laboratory parameters, as well as outcomes.
Of the 33 confirmed measles cases admitted, 24 patients were tested for HIV infection and 18 tested seropositive. There were no significant differences in the demographics, clinical findings or laboratory data when comparing the HIV-positive and HIV-negative cases. Serious clinical manifestations were seen more frequently in HIV-positive patients (odds ratio [OR] 5, 95% confidence interval [CI] 0.48-51.8, = 0.34). One of the six patients testing HIV-negative developed pneumonia, while six of the 18 HIV-positive patients had a course complicated by pneumonia. Five of these HIV-positive patients required admission to the intensive care unit, three developing respiratory failure necessitating mechanical ventilation. HIV-positive patients had several other manifestations, including acute kidney injury, purulent conjunctivitis, pancreatitis and encephalitis. HIV-positive patients had a significantly longer hospital stay ( = 0.03). There were three deaths in the HIV-positive group, but none in the HIV-negative group (OR 2.9, 95% CI 0.13-65.3, = 0.55).
Our study provides data on the largest series of hospitalised adults infected with HIV and co-infected with measles. More severe consequences seemed to occur in hospitalised HIV-positive patients.
尽管麻疹传统上是一种儿童疾病，但成人病例的数量正在增加。尽管麻疹和艾滋病毒感染在撒哈拉以南非洲均为地方病，但关于合并感染患者的预后数据却很少。
比较确诊为麻疹的成年艾滋病毒感染患者和未感染艾滋病毒的成年患者的人口统计学、临床、实验室和影像学特征，以及预后（住院时间、并发症和死亡率）。
我们对2009年和2010年南非麻疹疫情高峰期入住夏洛特·马克西克约翰内斯堡学术医院传染病科的确诊麻疹成年患者进行了回顾性病历审查。收集的数据包括人口统计学、临床和实验室参数以及预后情况。
在33例确诊的麻疹病例中，24例患者接受了艾滋病毒感染检测，18例血清检测呈阳性。比较艾滋病毒阳性和阴性病例时，在人口统计学、临床发现或实验室数据方面没有显著差异。艾滋病毒阳性患者更常出现严重临床表现（优势比[OR]为5，95%置信区间[CI]为0.48 - 51.8，P = 0.34）。6例艾滋病毒检测阴性的患者中有1例发生肺炎，而18例艾滋病毒阳性患者中有6例病程并发肺炎。这些艾滋病毒阳性患者中有5例需要入住重症监护病房，3例发生呼吸衰竭需要机械通气。艾滋病毒阳性患者还有其他几种表现，包括急性肾损伤、脓性结膜炎、胰腺炎和脑炎。艾滋病毒阳性患者的住院时间明显更长（P = 0.03）。艾滋病毒阳性组有3例死亡，而艾滋病毒阴性组无死亡（OR为2.9，95% CI为0.13 - 65.3，P = 0.55）。
我们的研究提供了关于感染艾滋病毒并合并感染麻疹的住院成年患者的最大系列数据。住院的艾滋病毒阳性患者似乎会出现更严重的后果。
