Meynard J L, Guiguet M, Arsac S, Frottier J, Meyohas M C
Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France.
AIDS. 1997 Jul;11(8):995-8. doi: 10.1097/00002030-199708000-00007.
To determine causes, incidence and factors associated with infections in neutropenic [polymorphonuclear neutrophil (PMN), 1000 x 10(6)/l] HIV-infected patients.
Prospective study.
Infectious disease service of a 1000-bed university teaching hospital in Paris, France.
HIV-infected patients with a PMN count of < 1000 x 10(6)/l confirmed on two occasions were included in the study. Baseline characteristics, cause of neutropenia and occurrence of infectious episodes were analysed.
The cause of neutropenia was lymphoma in four cases (6.5%), antineoplastic chemotherapy in seven (11.3%), zidovudine in 32 (51%), trimethoprim-sulphamethoxazole (TMP-SMX) in 28 (45%) and ganciclovir in 11 (18%). Fifteen patients (24%) developed infectious complications. Neutropenia induced by chemotherapy or lymphoma was more frequently complicate by infectious episodes (P = 0.02). Neutropenia in the previous 3 months (P = 0.05), presence of a central venous catheter (P = 0.05) and a trough PMN count (P = 0.02) were the three risk factors of infection retained in a logistic model.
Neutropenia induced by zidovudine, gangiclovir or TMP-SMX, are less complicated by infectious episodes than neutropenia induced by antineoplastic chemotherapy. Overall, infectious episodes in neutropenic HIV-infected patients appear lower than in patients with haemobiologic malignancies.
确定中性粒细胞减少（多形核中性粒细胞[PMN]，<1000×10⁶/l）的HIV感染患者感染的原因、发生率及相关因素。
前瞻性研究。
法国巴黎一家拥有1000张床位的大学教学医院的传染病科。
两次确诊PMN计数<1000×10⁶/l的HIV感染患者纳入研究。分析基线特征、中性粒细胞减少的原因及感染发作情况。
中性粒细胞减少的原因，4例（6.5%）为淋巴瘤，7例（11.3%）为抗肿瘤化疗，32例（51%）为齐多夫定，28例（45%）为复方新诺明，11例（18%）为更昔洛韦。15例患者（24%）发生感染并发症。化疗或淋巴瘤所致中性粒细胞减少更常并发感染发作（P = 0.02）。前3个月的中性粒细胞减少（P = 0.05）、中心静脉导管的存在（P = 0.05）和PMN谷值计数（P = 0.02）是逻辑模型中保留的三个感染危险因素。
齐多夫定、更昔洛韦或复方新诺明所致中性粒细胞减少，与抗肿瘤化疗所致中性粒细胞减少相比，感染发作并发症较少。总体而言，中性粒细胞减少的HIV感染患者的感染发作似乎低于血液系统恶性肿瘤患者。
