Characterising HIV-Indicator conditions among two nationwide long-term cohorts of people living with HIV in Germany (1999-2023).

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-10-30 DOI:10.1007/s15010-024-02419-2

Amrei Krings, Christian Kollan, Daniel Schmidt, Barbara Gunsenheimer-Bartmeyer, Frederik Valbert, Anja Neumann, Jürgen Wasem, Georg M N Behrens, Markus Bickel, Christoph Boesecke, Stefan Esser, Patrik Dröge, Thomas Ruhnke, Uwe Koppe

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Abstract

Background/objective: Information about occurrence and affected groups of symptoms/diagnoses indicative of an HIV infection (so-called HIV indicator conditions; HIV-ICs) is lacking. We analyse HIV-IC incidence, transmission risks and immune status among people living with HIV (PLWH) antiretroviral therapy (ART) naive.

Methods: Diagnoses reported for ART-naive PLWH from two multicentre observational, prospective cohort studies between 1999-2023 were analysed. Incidence rates per 1,000 person-years (PYs) were calculated for the overall study period and time periods defined by ART treatment recommendations. For further description, CD4 counts around HIV-IC diagnosis (+ -30 days) and HIV-transmission routes were collected.

Results: In total 15,940 diagnoses of 18,534 PLWH in Germany were included. Of those 81% were male (median age: 36 years) and 56% reported being men, who have sex with men as the likely HIV-transmission route. Incidence rates varied between the different HIV-ICs. Syphilis had the highest incidence rate (34 per 1,000 PYs; 95% confidence interval [CI] 29-40) for sexually transmitted infections (STIs), hepatitis B was highest for viral hepatitis diagnoses (18 per 1,000 PYs; 95% CI 17-20); according to CDC-classification herpes zoster for HIV-associated diagnoses (22 per 1,000; 95% CI 20-24) and candidiasis for AIDS-defining diagnoses (30 per 1,000 PYs; 95% CI 29-32). Most PLWH with HIV-ICs (hepatitis, HIV-associated diagnoses and AIDS-defining conditions) had CD4 cell counts < 350.

Conclusion: This analysis characterizes HIV-ICs regarding the incidence, HIV-transmission route and patients' immune status. The results underline the importance of HIV-IC-based screening to detect PLWH with already partially impaired immune status and in need of timely ART initiation.

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德国两个全国性艾滋病毒感染者长期队列（1999-2023 年）的艾滋病毒指标情况特征。

背景/目的：目前尚缺乏有关艾滋病毒感染症状/诊断（即所谓的艾滋病毒指标状况；HIV-ICs）的发生率和受影响群体的信息。我们分析了未接受抗逆转录病毒疗法（ART）的艾滋病病毒感染者（PLWH）中 HIV-IC 的发生率、传播风险和免疫状态：方法：分析了 1999-2023 年间两项多中心前瞻性队列研究中报告的抗逆转录病毒疗法未接受治疗的艾滋病毒感染者的诊断结果。计算了整个研究期间和根据抗逆转录病毒疗法治疗建议确定的时间段内每千人年 (PY) 的发病率。为了进一步说明情况，还收集了 HIV-IC 诊断前后（+-30 天）的 CD4 计数和 HIV 传播途径：结果：共纳入了德国 18,534 名艾滋病毒感染者中的 15,940 例诊断结果。其中 81% 为男性（年龄中位数：36 岁），56% 的人称自己是男性，而男性同性性行为可能是 HIV 的传播途径。不同艾滋病毒感染病例的发病率各不相同。在性传播感染中，梅毒的发病率最高（34‰；95% 置信区间 [CI] 29-40）；在病毒性肝炎诊断中，乙型肝炎的发病率最高（18‰；95% 置信区间 17-20）；根据疾病预防控制中心的分类，带状疱疹的发病率在艾滋病毒相关诊断中最高（22‰；95% 置信区间 20-24），念珠菌病的发病率在艾滋病定义诊断中最高（30‰；95% 置信区间 29-32）。大多数感染了 HIV-ICs（肝炎、HIV 相关诊断和艾滋病定义病症）的 PLWH 的 CD4 细胞计数为结论：这项分析从发病率、艾滋病病毒传播途径和患者免疫状况等方面描述了艾滋病病毒感染性疾病的特征。结果突出表明，基于 HIV-IC 的筛查对于发现免疫状况已经部分受损、需要及时开始抗逆转录病毒疗法的 PLWH 非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.