Song Alice Tung Wan, Schout Denise, Novaes Hillegonda Maria Dutilh, Goldbaum Moisés
Department of Preventive Medicine, Hospital das Clínicas, Faculty of Medicine, University of São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 2003 Jul-Aug;58(4):207-14. doi: 10.1590/s0041-87812003000400004. Epub 2003 Sep 30.
Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo.
Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases.
During the period, 559 patients were identified as presenting with AIDS/tuberculosis comorbidity. Risk behavior for AIDS was primarily heterosexual contact (38.9%), followed by intravenous drug use (29.3%) and homosexual/bisexual contact (23.2%). Regarding clinical features, there were higher rates of extrapulmonary tuberculosis when compared to tuberculosis without comorbidity. There was an increase in reporting of AIDS by ambulatory units during the period. Epidemiologically, there was a decrease in the male/female ratio, a predominance in the 20 to 39 year-old age group, and a majority of individuals who had less than 8 years of schooling and had low professional qualifications.
High rates of AIDS/tuberculosis cases at our hospital indicate the need for better attention towards early detection of tuberculosis, especially in its extrapulmonary form. Since the population that attends this hospital tends to be of a lower socioeconomic status, better management of AIDS and tuberculosis is required to increase the rates of treatment adherence and thus lower the social costs.
考虑到艾滋病/结核病合并感染在全球尤其是巴西的相关性,本研究旨在描述圣保罗大学临床医院流行病学服务部门于1989年至1997年期间确定的合并感染病例的临床和流行病学特征。
利用包含该医院所有确诊的艾滋病/结核病病例信息的数据库来收集合并感染病例的信息。
在此期间,共确定559例患者患有艾滋病/结核病合并感染。艾滋病的风险行为主要是异性接触(38.9%),其次是静脉吸毒(29.3%)和同性恋/双性恋接触(23.2%)。关于临床特征,与非合并感染的结核病相比,肺外结核病的发生率更高。在此期间,门诊单位报告的艾滋病病例有所增加。从流行病学角度看,男女比例下降,20至39岁年龄组占主导,大多数患者受教育年限不足8年且职业资格较低。
我院艾滋病/结核病合并感染病例的高发生率表明需要更加关注结核病的早期检测,尤其是肺外形式的结核病。由于到我院就诊的人群社会经济地位往往较低,因此需要更好地管理艾滋病和结核病,以提高治疗依从率,从而降低社会成本。