Sorvillo F, Beall G, Turner P A, Beer V L, Kovacs A A, Kraus P, Masters D, Kerndt P R
HIV Epidemiology Program, Los Angeles County Department of Health Serivces, Los Angeles, CA 90005, USA.
Epidemiol Infect. 1998 Aug;121(1):197-204. doi: 10.1017/s0950268898001009.
The seasonality and factors associated with Cryptosporidium infection were assessed in a cohort of HIV-infected patients in Los Angeles County to better define the epidemiology of cryptosporidiosis among individuals with HIV. Data were analysed from a cohort of 4247 patients > or = 13 years of age with HIV infection enrolled from four outpatient facilities in Los Angeles, 1990-6. Cryptosporidiosis was diagnosed in 120 (2.8%) patients. Among the 1296 individuals with complete follow-up until death, cryptosporidiosis occurred in 69 (5.3%). The seasonal rate of cryptosporidiosis showed a modest bimodal trend with the highest rates occurring in March-May and September-October. There was no difference in the rate of cryptosporidiosis for the periods of heaviest rainfall (December-March) and low rainfall (April-November). Infection rates were higher among males (1.59 per 100 person-years) than females (0.92) and lower in blacks (0.98) than other racial/ethnic groups (1.80). A significant trend of decreasing cryptosporidiosis was observed with increasing age, with the highest rate (2.34) in the 13-34 year age group. A strong association between cryptosporidiosis and CD4+ count was noted. These data suggest that cryptosporidiosis among HIV-infected individuals in Los Angeles County exhibits a modest spring and fall seasonality. This pattern of occurrence of cryptosporidiosis appears temporally unrelated to local rainfall patterns. Our findings suggest that HIV-infected men, individuals in younger age groups and those with CD4+ lymphocyte counts < 100 x 10(6)/l are at increased risk of cryptosporidiosis. Blacks with HIV infection appear less likely than other racial/ethnic groups to be diagnosed with Cryptosporidium infection. These results may provide insight into possible routes of transmission and sources of cryptosporidiosis infection in individuals with HIV.
为了更好地界定艾滋病毒感染者隐孢子虫病的流行病学特征，在洛杉矶县的一组艾滋病毒感染患者中评估了与隐孢子虫感染相关的季节性和因素。分析了1990年至1996年期间从洛杉矶四个门诊机构招募的4247名年龄≥13岁的艾滋病毒感染患者队列的数据。120名（2.8%）患者被诊断为隐孢子虫病。在1296名有完整随访直至死亡的个体中，69名（5.3%）发生了隐孢子虫病。隐孢子虫病的季节性发病率呈适度的双峰趋势，最高发病率出现在3月至5月和9月至10月。降雨量最大时期（12月至3月）和降雨量低时期（4月至11月）的隐孢子虫病发病率没有差异。男性的感染率（每100人年1.59例）高于女性（0.92例），黑人的感染率（0.98例）低于其他种族/族裔群体（1.80例）。随着年龄增长，隐孢子虫病发病率呈显著下降趋势，13至34岁年龄组的发病率最高（2.34）。隐孢子虫病与CD4 + 细胞计数之间存在密切关联。这些数据表明，洛杉矶县艾滋病毒感染者中的隐孢子虫病呈现出适度的春秋季节性。这种隐孢子虫病的发生模式在时间上似乎与当地降雨模式无关。我们的研究结果表明，艾滋病毒感染男性、年轻年龄组个体以及CD4 + 淋巴细胞计数<100×10⁶ /L的个体感染隐孢子虫病的风险增加。感染艾滋病毒的黑人被诊断为隐孢子虫感染的可能性似乎低于其他种族/族裔群体。这些结果可能有助于深入了解艾滋病毒感染者隐孢子虫病的可能传播途径和感染源。
