Lawson Lovett, Yassin Mohammed A, Thacher Tom D, Olatunji Olubunmi O, Lawson Juliana O, Akingbogun Titi I, Bello Cornelius S S, Cuevas Luis E, Davies Peter D O
Zankli Medical Centre, Abuja, Nigeria.
Scand J Infect Dis. 2008;40(1):30-5. doi: 10.1080/00365540701509899. Epub 2007 Jul 10.
Our aim was to describe the frequency of HIV infection among patients with tuberculosis and compare their characteristics with patients with TB but not infected with HIV. Patients with cough >3 weeks duration attending 8 hospitals in Abuja, Nigeria were screened with smear microscopy and culture and tested for HIV. Chest X-rays were graded by 2 readers. 731 (62%) of 1186 patients had positive cultures and 353 (48%) of these 731 patients were smear positive. 1002 (85%) patients were tested for HIV and 546 (55%) were positive. 53% (329/625) of the culture positive patients and 58% (217/377) of the culture negative patients were HIV positive. Anorexia, weight loss, low BMI (<18.5), haemoglobin (<11 gm/dl) and albumin and high ESR and liver enzymes were more frequently observed among patients with TB coinfected with HIV than in patients without HIV. Coinfected patients had less cavitations and lung involvement on X-rays than patients without HIV. In conclusion, the prevalence of HIV is very high among patients with TB in Abuja, Nigeria. The presence of HIV decreases the sensitivity of smear microscopy and complicates the diagnosis of TB. Selected clinical and laboratory parameters could be used to identify individuals with TB who are likely to be coinfected with HIV.
我们的目的是描述结核病患者中艾滋病毒感染的频率，并将他们的特征与未感染艾滋病毒的结核病患者进行比较。在尼日利亚阿布贾的8家医院就诊、咳嗽持续时间超过3周的患者接受了涂片显微镜检查、培养及艾滋病毒检测。胸部X光片由两名阅片者进行分级。1186名患者中有731名（62%）培养结果呈阳性，在这731名患者中，353名（48%）涂片呈阳性。1002名（85%）患者接受了艾滋病毒检测，其中546名（55%）呈阳性。培养阳性患者中有53%（329/625）、培养阴性患者中有58%（217/377）艾滋病毒呈阳性。与未感染艾滋病毒的患者相比，艾滋病毒合并感染的结核病患者更常出现厌食、体重减轻、低体重指数（<18.5）、血红蛋白水平低（<11 gm/dl）、白蛋白水平低以及血沉和肝酶升高。与未感染艾滋病毒的患者相比，合并感染的患者X光片上的空洞和肺部受累情况较少。总之，在尼日利亚阿布贾的结核病患者中，艾滋病毒的患病率非常高。艾滋病毒的存在降低了涂片显微镜检查的敏感性，并使结核病的诊断变得复杂。选定的临床和实验室参数可用于识别可能合并感染艾滋病毒的结核病患者。
