Ledru E, Diagbouga S, Meda N, Sanou P T, Dahourou H, Ledru S, Dembelé A, Zoubga A, Durand G
Centre Muraz (Organisation de Coordination et de Coopération pour la Lutte contre les Grandes Endémies) Bobo-Dioulasso, Burkina Faso, Africa.
Int J STD AIDS. 1998 Aug;9(8):463-70. doi: 10.1258/0956462981922638.
Our objective was to propose a strategy to screen HIV-infected African people for biological immunodeficiency easily. In a cross-sectional study, we analysed the patterns of diseases and of CD4 counts among 266 HIV-infected adults. Peripheral facial paralysis and chronic cutaneo-mucous diseases were the earlier B-stage diseases. Pulmonary tuberculosis was close to B-stage diseases, and chronic diarrhoea was borderline between B and C stages. Cachexia was the most frequent C-stage symptom (47.8%). Ninety per cent of CDC-C stage people had CD4 counts below 350/microliter, whereas only 75% had CD4 counts below 200/microliter. Regression analysis identified the lymphocyte count, clinical stage and platelet count as predictors of CD4 count below 350/microliter. A simple score (lymphocyte count < or = 2500/microliter and clinical stage > or = B) is proposed to determine this CD4 threshold (positive predictive value: 83%) and to determine those patients needing treatment to prevent wasting and opportunistic infections.
我们的目标是提出一种策略，以便轻松地对感染艾滋病毒的非洲人进行生物免疫缺陷筛查。在一项横断面研究中，我们分析了266名感染艾滋病毒的成年人的疾病模式和CD4细胞计数情况。周围性面瘫和慢性皮肤黏膜疾病是较早出现的B期疾病。肺结核接近B期疾病，慢性腹泻处于B期和C期之间的临界状态。恶病质是最常见的C期症状（47.8%）。90%的美国疾病控制与预防中心（CDC）C期患者CD4细胞计数低于350/微升，而只有75%的患者CD4细胞计数低于200/微升。回归分析确定淋巴细胞计数、临床分期和血小板计数是CD4细胞计数低于350/微升的预测指标。我们提出了一个简单的评分标准（淋巴细胞计数≤2500/微升且临床分期≥B期）来确定这一CD4阈值（阳性预测值：83%），并确定那些需要治疗以预防消瘦和机会性感染的患者。
