Tangüis H G, Caylà J A, García de Olalla P G, Jansà J M, Brugal M T
Epidemiology Service, Municipal Institute of Public Health of Barcelona, Spain.
Int J Tuberc Lung Dis. 2000 Jan;4(1):55-60.
To determine the predictive factors of non-completion of tuberculosis (TB) treatment among patients infected with the human immunodeficiency virus (HIV).
Between 1987 and 1996, 2201 HIV-infected TB patients were detected by the Barcelona Tuberculosis Prevention and Control Programme. Patients who completed treatment were compared to those who abandoned. Bivariate analysis was made by chi(2) test to compare qualitative variables. Associations were measured by means of odds ratios (OR) with 95% confidence intervals (CI). Variables showing a statistically significant association were analysed at multivariate level by means of a logistic regression model.
Treatment was carried to completion by 1065 patients (48.4%), 289 (13.1%) abandoned, 648 (29.5%) died during treatment, and 142 (6.5%) moved out of the city. Final outcome could not be established in 57 (2.5%). Intravenous drug users (IDU) represented 76.2% of patients. The rate of non-completion between 1987 and 1992 was 26.3% and for 1993-1996 it was 15.1%, a decrease of 42.6%. Living in neighbourhoods of a low socio-economic level (OR 1.61; 95% CI 1.222.13), homelessness (OR 3.56; 95% CI 2.01-6.31), history of TB (OR 1.61; 95% CI 1.12-2.33), and having presented with a current TB episode in 1987-1992 (OR 1.42; 95% CI 1.01-2.00), were risk factors for abandoning TB treatment.
Social and health factors together influence non-completion of TB treatment in HIV-infected patients, while health interventions can improve treatment completion.
确定感染人类免疫缺陷病毒（HIV）的结核病（TB）患者未完成治疗的预测因素。
1987年至1996年间，巴塞罗那结核病预防与控制项目检测出2201例HIV感染的TB患者。将完成治疗的患者与放弃治疗的患者进行比较。通过卡方检验进行双变量分析以比较定性变量。采用比值比（OR）及95%置信区间（CI）衡量关联度。对显示有统计学显著关联的变量，通过逻辑回归模型在多变量水平进行分析。
1065例患者（48.4%）完成了治疗，289例（13.1%）放弃治疗，648例（29.5%）在治疗期间死亡，142例（6.5%）迁出该市。57例（2.5%）患者的最终结局无法确定。静脉吸毒者（IDU）占患者的76.2%。1987年至1992年期间未完成治疗的比例为26.3%，1993年至1996年为15.1%，下降了42.6%。社会经济水平较低社区的居民（OR 1.61；95% CI 1.22 - 2.13）、无家可归者（OR 3.56；95% CI 2.01 - 6.31）、有结核病病史（OR 1.61；95% CI 1.12 - 2.33）以及在1987 - 1992年期间出现当前结核病发作（OR 1.42；95% CI 1.01 - 2.00），均为放弃结核病治疗的危险因素。
社会和健康因素共同影响HIV感染患者结核病治疗的未完成情况，而健康干预措施可提高治疗完成率。
