Janoff E N, O'Brien J, Thompson P, Ehret J, Meiklejohn G, Duvall G, Douglas J M
Department of Medicine, VA Medical Center, Minneapolis, MN 55417.
J Infect Dis. 1993 Jan;167(1):49-56. doi: 10.1093/infdis/167.1.49.
Although invasive pneumococcal infections are common among men infected with human immunodeficiency virus (HIV), the prevalence of pharyngeal colonization with Streptococcus pneumoniae was not significantly different among HIV-infected patients (8 [14%] of 56) and HIV-seronegative men (9 [9%] of 99) attending a sexually transmitted disease clinic. Sixteen HIV-infected men (mean CD4+ T cell count, 132 +/- 37/microL) developed pneumococcal bacteremia, accounting for 13.6% of 117 total cases and 42% of 38 cases in men 16-55 years old. Serum killing activity, a measure of functional humoral response to S. pneumoniae, was lower in 4 (67%) of 6 acute sera and 6 (54%) of 11 convalescent sera from bacteremic HIV-infected patients when compared with baseline sera of 7 HIV-seronegative healthy subjects. These findings suggest that the high rates of pneumococcal bacteremia among HIV-infected patients may be associated with low numbers of CD4+ T cells and impaired humoral responses to S. pneumoniae rather than to increased exposure to the organism.
虽然侵袭性肺炎球菌感染在感染人类免疫缺陷病毒（HIV）的男性中很常见，但在一家性传播疾病诊所就诊的HIV感染患者（56例中的8例[14%]）和HIV血清阴性男性（99例中的9例[9%]）中，肺炎链球菌咽部定植的发生率并无显著差异。16例HIV感染男性（平均CD4 + T细胞计数为132±37/μL）发生了肺炎球菌菌血症，占117例总病例的13.6%，占16 - 55岁男性38例病例的42%。与7名HIV血清阴性健康受试者的基线血清相比，菌血症HIV感染患者的6份急性血清中的4份（67%）和11份恢复期血清中的6份（54%）的血清杀菌活性（一种对肺炎链球菌的功能性体液反应指标）较低。这些发现表明，HIV感染患者中肺炎球菌菌血症的高发生率可能与CD4 + T细胞数量少以及对肺炎链球菌的体液反应受损有关，而非与接触该病原体增加有关。
