Jones J L, Fleming P L, Ciesielski C A, Hu D J, Kaplan J E, Ward J W
Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
J Infect Dis. 1995 Apr;171(4):961-6. doi: 10.1093/infdis/171.4.961.
Adults and adolescents diagnosed with AIDS from 1987 through 1992 residing in counties endemic (selected counties in California, Arizona, Texas, New Mexico, Nevada, Utah) and not endemic for Coccidioides immitis were assessed to determine the frequency of and risk factors for disseminated coccidioidomycosis. Of 602 AIDS patients reported with disseminated coccidioidomycosis, 323 (1.1% of AIDS patients) resided in C. immitis-endemic counties and 279 (0.1% of AIDS patients) resided in C. immitis-nonendemic counties in 35 states. In multivariate analysis, patients with disseminated coccidioidomycosis in C. immitis-endemic counties were more likely to be injecting drug users (odds ratio, 2.6; 95% confidence interval, 1.8-3.7) and blood product recipients (odds ratio, 3.6; 95% confidence interval, 1.5-8.3) than to be homosexual or bisexual men. Of patients with disseminated coccidioidomycosis, 63% had died by 1 year after AIDS diagnosis. Disseminated coccidioidomycosis should be considered in AIDS patients in all areas of the United States.
对1987年至1992年期间被诊断患有艾滋病的成年人及青少年进行评估，这些患者居住在球孢子菌病流行的县（加利福尼亚州、亚利桑那州、得克萨斯州、新墨西哥州、内华达州、犹他州的部分县）以及非球孢子菌病流行地区，以确定播散性球孢子菌病的发病频率及危险因素。在报告患有播散性球孢子菌病的602例艾滋病患者中，323例（占艾滋病患者的1.1%）居住在球孢子菌病流行的县，279例（占艾滋病患者的0.1%）居住在35个州的非球孢子菌病流行的县。多因素分析显示，在球孢子菌病流行县患有播散性球孢子菌病的患者，比起同性恋或双性恋男性，更有可能是注射吸毒者（比值比为2.6；95%置信区间为1.8 - 3.7）和血液制品接受者（比值比为3.6；95%置信区间为1.5 - 8.3）。在患有播散性球孢子菌病的患者中，63%在艾滋病诊断后1年内死亡。在美国所有地区的艾滋病患者中都应考虑播散性球孢子菌病。
