Holmberg S D, Buchbinder S P, Conley L J, Wong L C, Katz M H, Penley K A, Hershow R C, Judson F N
Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329-4018.
Am J Epidemiol. 1995 Mar 1;141(5):395-404; discussion 405-6. doi: 10.1093/oxfordjournals.aje.a117441.
The full range and occurrence of medical conditions in persons infected with human immunodeficiency virus (HIV) before they develop illnesses that define acquired immunodeficiency syndrome (AIDS) have not been systematically or completely described. In a retrospective and prospective cohort study, 1,073 homosexual and bisexual men in three US cities were interviewed and examined twice per year from January 1988 to September 1992. Study participants were from San Francisco, California (273 HIV-seropositive and 432 HIV-seronegative men), Denver, Colorado (107 positive and 129 negative men), and Chicago, Illinois (54 positive and 78 negative men). A total of 305 HIV-positive men had specifiable dates of HIV seroconversion (mean of 15.3 months between the last negative and the first positive HIV antibody test). Besides much increased incidences of thrush (incidence relative risk (IRR) = 23.3) and hairy leukoplakia (IRR = 551), the following conditions also occurred significantly more frequently in HIV-positive men than in HIV-negative men: anal herpes (incidence density (ID) = 10.7/100 person-years; IRR = 7.7); sinusitis requiring antibiotics (ID = 6.2/100 person-years; IRR = 2.1); anal warts (ID = 5.8/100 person-years; IRR = 2.7); seborrhea (ID = 3.8/100 person-years; IRR = 6.6); community-acquired pneumonia (ID = 1.4/100 person-years; IRR = 2.7); skin cancers (ID = 1.0/100 person-years; IRR = 2.2); and seizures, often apparently "breaking through" prior anticonvulsant therapy (ID = 0.8/100 person-years; IRR = 5.6). First episodes of hairy leukoplakia, thrush, and skin cancer occurred at low mean CD4 counts (mean counts were less than 350 cells/microliters) and late in HIV infection (mean times were more than 8 years after HIV seroconversion). Many medical problems, some not widely appreciated, occur in HIV-infected men before they develop AIDS-defining illnesses, signifying considerable morbidity from pre-AIDS HIV infection.
在感染人类免疫缺陷病毒（HIV）的人群中，在发展为定义获得性免疫缺陷综合征（AIDS）的疾病之前，其全部的医学状况范围及发生情况尚未得到系统或完整的描述。在一项回顾性和前瞻性队列研究中，1988年1月至1992年9月期间，对美国三个城市的1073名同性恋和双性恋男性每年进行两次访谈和检查。研究参与者来自加利福尼亚州旧金山（273名HIV血清阳性和432名HIV血清阴性男性）、科罗拉多州丹佛（107名阳性和129名阴性男性）以及伊利诺伊州芝加哥（54名阳性和78名阴性男性）。共有305名HIV阳性男性有明确的HIV血清转换日期（最后一次阴性和第一次阳性HIV抗体检测之间的平均间隔为15.3个月）。除了鹅口疮（发病相对风险（IRR）=23.3）和毛状白斑（IRR = 551）的发病率大幅增加外，以下疾病在HIV阳性男性中的发生频率也显著高于HIV阴性男性：肛门疱疹（发病密度（ID）=10.7/100人年；IRR = 7.7）；需要使用抗生素的鼻窦炎（ID = 6.2/100人年；IRR = 2.1）；肛门疣（ID = 5.8/100人年；IRR = 2.7）；脂溢性皮炎（ID = 3.8/100人年；IRR = 6.6）；社区获得性肺炎（ID = 1.4/100人年；IRR = 2.7）；皮肤癌（ID = 1.0/100人年；IRR = 2.2）；以及癫痫发作，常常明显“突破”先前的抗惊厥治疗（ID = 0.8/100人年；IRR = 5.6）。毛状白斑、鹅口疮和皮肤癌的首次发作发生在CD4细胞计数较低时（平均计数低于每微升350个细胞）且在HIV感染后期（平均时间为HIV血清转换后超过8年）。许多医学问题，有些尚未得到广泛认识，在HIV感染男性发展为定义AIDS的疾病之前就已出现，这表明AIDS前期HIV感染会导致相当高的发病率。
