Delmas M C, Schwoebel V, Heisterkamp S H, Downs A M, Ancelle-Park R A, Brunet J B
European Centre for the Epidemiological Monitoring of AIDS, Saint-Maurice, France.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 May 1;9(1):74-80.
We analyzed the proportion of AIDS cases with Pneumocystis carinii pneumonia (PCP) at diagnosis among the 43,198 adult AIDS cases diagnosed since January 1988 and reported by June 1992 in Austria, Belgium, France, Germany, Italy, Portugal, Switzerland, United Kingdom, and the city of Amsterdam. In multivariate analysis, the risk of having PCP at AIDS diagnosis decreased slightly with increasing age and was strongly associated with country of diagnosis, transmission category, and year of diagnosis, but not with gender. Since 1989, the proportion of AIDS cases with PCP decreased significantly among homosexual and bisexual men in five of the nine countries examined and among injecting drug users in four of seven countries. In three countries with sufficient data for analysis, no significant decrease was seen among heterosexual patients with a partner originating from a country where heterosexual transmission is common (i.e., Africa/Caribbean). Among other heterosexual patients, a significant decreasing trend was demonstrated in only one of six countries analyzed. For all countries combined, the decrease was significant among hemophiliacs and of borderline significance among transfusion recipients. Results suggest that medical management before AIDS diagnosis is not homogeneous among all human immunodeficiency virus (HIV)-infected persons in Europe. Efforts should be made to provide better information on the potential benefit of early HIV testing and to facilitate the use of preventive treatments.
我们分析了1988年1月至1992年6月期间在奥地利、比利时、法国、德国、意大利、葡萄牙、瑞士、英国以及阿姆斯特丹市确诊并报告的43198例成年艾滋病病例中，诊断时患有卡氏肺孢子虫肺炎（PCP）的艾滋病病例所占比例。在多变量分析中，艾滋病诊断时患有PCP的风险随年龄增长略有降低，并且与诊断国家、传播类别和诊断年份密切相关，但与性别无关。自1989年以来，在所调查的9个国家中的5个国家，同性恋和双性恋男性艾滋病病例中PCP的比例显著下降；在7个国家中的4个国家，注射吸毒者中PCP的比例也显著下降。在有足够数据进行分析的3个国家中，来自异性传播常见国家（即非洲/加勒比地区）的异性伴侣的异性恋患者中，未观察到显著下降。在其他异性恋患者中，在分析的6个国家中只有1个国家呈现出显著下降趋势。对于所有国家综合来看，血友病患者中的下降显著，输血接受者中的下降接近显著。结果表明，在欧洲所有感染人类免疫缺陷病毒（HIV）的人群中，艾滋病诊断前的医疗管理并不统一。应努力提供关于早期HIV检测潜在益处的更好信息，并促进预防性治疗的使用。
