OUTCOMES OF SYMPTOMATIC EPISODES IN HIV INFECTION

HIV 感染症状发作的结果

基本信息

批准号：
2235815
负责人：
MARTIN F. SHAPIRO
金额：
$ 2.98万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
1991
资助国家：
美国
起止时间：
1991-04-01 至 1994-12-31
项目状态：
已结题

项目摘要

This prospective, longitudinal study will examine the clinical problem of symptomatic episodes that may present with sustained fever in patients with documented human immunodeficiency virus (HIV) infection. To contribute to the development of a comprehensive strategy for the diagnostic evaluation of these patients, the study will: 1) describe the spectrum, frequency and outcome of symptomatic episodes, 2) estimate the effects of medical procedures, fever and baseline health-related quality of life on ability to make diagnosis, mortality and subsequent health related quality of life, 3) characterize distinct clinical syndromes that allow a more focused investigation, 4) describe the yield of commonly used diagnostic tests, 5) identify patient characteristics that support either empiric therapy, intensive investigation or no therapy, and 6) develop predictive models for the yield of different diagnostic strategies and, where appropriate, diagnostic algorithms. The study will be conducted in a socioeconomically and racially diverse population, including at least 600 inpatients and outpatients at a county hospital (50%), and patients in four large practices devoted to the care of HIV-infected patients. (50%). Criteria for eligibility are: 1) documented positive HIV infection, or diagnosis of acquired immunodeficiency syndrome (AIDS), 2) ate > 18, and 3) either a) pulmonary symptoms, b) diarrhea or c) constitutional symptoms i) lasting at least 7 days or ii) resulting in initiation of specific therapy for a documented disorder. Patients will be enrolled at the time of documentation of a symptomatic episode and will be followed for no less than 12 months (unless death intervenes) and for up to 32 months. Using medical record review and patient interviews, and applying validated instruments to measure overall health status, the study will examine the usefulness of diagnostic investigation at different stages of the illness - overall and in subpopulations with the three clinical syndromes each with and without fever. The predictive models and algorithms that result from this study should allow efficient and appropriate investigation of patients with symptomatic illness with or without sustained fever, thereby avoiding unnecessary hospitalizations and excessive testing, and maximizing benefit to the patient.

这项前瞻性纵向研究将探讨以下临床问题：患者可能出现持续发烧的症状记录了人类免疫缺陷病毒（HIV）感染。为做出贡献制定诊断评估综合策略对于这些患者，研究将：1）描述频谱、频率和症状发作的结果，2）估计医疗效果程序、发烧和基线健康相关生活质量的能力进行诊断、死亡率和随后的健康相关生活质量， 3）描述不同的临床综合征的特征，以便更集中调查，4) 描述常用诊断测试的效果，5) 确定支持经验性治疗的患者特征，深入调查或不进行治疗，以及 6) 开发预测模型不同诊断策略的产量，以及在适当的情况下，诊断算法。该研究将在社会经济层面进行和不同种族的人口，包括至少 600 名住院患者和县医院门诊患者（50%）、四大医院门诊患者致力于护理艾滋病毒感染者的实践。（50%）。标准资格包括： 1) 有记录的 HIV 感染阳性，或诊断为获得性免疫缺陷综合症 (AIDS)，2) 饮食量 > 18，以及 3) a) 肺部症状，b) 腹泻或 c) 全身症状 i) 持续至少 7 天或 ii) 导致开始针对特定治疗记录的紊乱。患者将在以下时间入组记录症状发作并进行跟踪超过 12 个月（除非死亡干预）和最长 32 个月。使用病历审查和患者访谈，并应用经过验证的衡量整体健康状况的工具，该研究将检查在疾病的不同阶段进行诊断检查的有用性 - 总体而言以及具有三种临床综合征的亚群，每种综合征均具有并且没有发烧。本研究得出的预测模型和算法应允许对患者进行有效和适当的调查有或没有持续发烧的症状性疾病，从而避免不必要的住院治疗和过度检测，以及利益最大化给病人。