Wang F, So Y, Vittinghoff E, Malani H, Reingold A, Lewis E, Giordano J, Janssen R
School of Public Health, University of California/Berkeley, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):75-82.
We undertook this study to determine the incidence proportion of and risk factors for AIDS patients diagnosed with human immunodeficiency virus (HIV) dementia, central nervous system (CNS) toxoplasmosis, and cryptococcal meningitis. A historical cohort of 487 consecutive inpatients with AIDS treated by San Francisco General Hospital inpatient and outpatient services entered the study. We abstracted all available records for demographic information, diagnoses, and dates of death and estimated the incidence proportion of AIDS patients diagnosed with major CNS complications using the Kaplan-Meier method. We used the Cox proportional hazards model to analyze the effect of demographic factors on the hazard (risk per unit time) of diagnosis with these CNS conditions. The estimated incidence proportion of patients diagnosed with HIV dementia within 1 and 2 years of AIDS diagnosis increased from 0.10 to 0.18. Corresponding proportions were 0.10 and 0.19 for CNS toxoplasmosis and 0.10 and 0.14 for cryptococcal meningitis. Only HIV dementia was independently associated with increasing age at AIDS diagnosis (relative hazard [RH] of 2.75 for ages 41-50 [95% confidence interval, 1.08-6.98]; RH of 4.73 for ages > 50 [95% confidence interval, 1.41-15.87]) and with injection drug use (RH of 2.03; 95% confidence interval, 1.19-3.47). HIV dementia, CNS toxoplasmosis, and cryptococcal meningitis are about equally common complications in patients with AIDS, but only HIV dementia is associated with increasing age at AIDS diagnosis and injection drug use.
我们开展这项研究是为了确定被诊断患有人类免疫缺陷病毒（HIV）痴呆症、中枢神经系统（CNS）弓形虫病和隐球菌性脑膜炎的艾滋病患者的发病比例及危险因素。一个由旧金山综合医院住院部和门诊部连续治疗的487例艾滋病住院患者组成的历史性队列进入了该研究。我们提取了所有可用记录中的人口统计学信息、诊断结果和死亡日期，并使用Kaplan-Meier方法估计了被诊断患有主要中枢神经系统并发症的艾滋病患者的发病比例。我们使用Cox比例风险模型分析人口统计学因素对这些中枢神经系统疾病诊断风险（单位时间风险）的影响。在艾滋病诊断后1年和2年内被诊断患有HIV痴呆症的患者估计发病比例从0.10增至0.18。中枢神经系统弓形虫病的相应比例分别为0.10和0.19，隐球菌性脑膜炎的相应比例分别为0.10和0.14。只有HIV痴呆症与艾滋病诊断时年龄增加独立相关（41 - 50岁时相对风险[RH]为2.75[95%置信区间，1.08 - 6.98]；年龄>50岁时RH为4.73[95%置信区间，1.41 - 15.87]）以及与注射吸毒相关（RH为2.03；95%置信区间，1.19 - 3.47）。HIV痴呆症、中枢神经系统弓形虫病和隐球菌性脑膜炎在艾滋病患者中是大致同样常见的并发症，但只有HIV痴呆症与艾滋病诊断时年龄增加和注射吸毒相关。
