Montaner J S, Le T, Hogg R, Ricketts M, Sutherland D, Strathdee S A, O'Shaughnessy M, Schechter M T
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
AIDS. 1994 May;8(5):693-6. doi: 10.1097/00002030-199405000-00018.
To describe the changing spectrum of AIDS index diseases in Canada over a 10-year period from 1981 to 1991.
A descriptive, population-based study.
Canada.
All cases of AIDS in Canada reported by the Division of HIV/AIDS Epidemiology of the Department of National Health and Welfare.
Age-standardized rates of initial AIDS manifestations (1987 Centers for Disease Control and Prevention case definition), by year of diagnosis among adults in Canada.
A total of 6641 adult AIDS cases were examined. The rate of Pneumocystis carinii pneumonia (PCP) peaked in 1989 with a rate of 3.18 per 100,000, declining to 2.74 per 100,000 in 1991 (P = 0.894). Similarly, the rate of Kaposi's sarcoma (KS) stabilized during this interval from 1.06 per 100,000 in 1987 to 1.14 per 100,000 in 1991 (P = 0.189). In contrast, the rates of all other AIDS-defining illnesses increased from 1.48 per 100,000 in 1987 to 3.43 per 100,000 in 1991 (P = 0.001). For these other AIDS index diseases, significant rate increases were observed for esophageal candidiasis, cytomegalovirus (CMV) diseases, wasting syndrome, toxoplasmosis, and Mycobacterium avium complex (MAC) disease.
Our study shows a leveling and decline in incidence of KS and PCP, respectively, and a concomitant increase of other diagnoses, especially esophageal candidiasis, CMV, wasting syndrome, toxoplasmosis, and MAC disease in Canada. These findings highlight the importance of developing specific strategies to prevent emerging AIDS index diseases and serve as a cautionary note to practicing clinicians, indicating the relative widening of the spectrum of HIV index diseases.
描述1981年至1991年这10年间加拿大艾滋病指标疾病谱的变化情况。
一项基于人群的描述性研究。
加拿大。
加拿大国家卫生与福利部艾滋病毒/艾滋病流行病学司报告的加拿大所有艾滋病病例。
按加拿大成年人诊断年份划分的初始艾滋病表现的年龄标准化发病率（1987年美国疾病控制与预防中心病例定义）。
共检查了6641例成人艾滋病病例。卡氏肺孢子虫肺炎（PCP）发病率在1989年达到峰值，为每10万人3.18例，1991年降至每10万人2.74例（P = 0.894）。同样，卡波西肉瘤（KS）发病率在此期间保持稳定，从1987年的每10万人1.06例升至1991年的每10万人1.14例（P = 0.189）。相比之下，所有其他艾滋病界定疾病的发病率从1987年的每10万人1.48例增至1991年的每10万人3.43例（P = 0.001）。对于这些其他艾滋病指标疾病，食管念珠菌病、巨细胞病毒（CMV）疾病、消瘦综合征、弓形虫病和鸟分枝杆菌复合体（MAC）疾病的发病率显著上升。
我们的研究表明，加拿大KS和PCP的发病率分别趋于平稳和下降，同时其他诊断疾病有所增加，尤其是食管念珠菌病、CMV、消瘦综合征、弓形虫病和MAC疾病。这些发现凸显了制定具体策略以预防新出现的艾滋病指标疾病的重要性，并向临床医生发出警示，表明艾滋病毒指标疾病谱相对变宽。
