Dubrovina I, Miskinis K, Lyepshina S, Yann Y, Hoffmann H, Zaleskis R, Nunn P, Zignol M
Project Office, World Health Organization, Donetsk, Ukraine.
Int J Tuberc Lung Dis. 2008 Jul;12(7):756-62.
To investigate anti-tuberculosis (TB) drug resistance rates in Donetsk Oblast, Ukraine, and to explore the association between the epidemics of human immunodeficiency virus (HIV) and multidrug-resistant TB (MDR-TB).
All consecutive newly diagnosed and previously treated patients with sputum smear-positive TB presenting to all TB units in Donetsk Oblast over 12 months were invited to take part in the study. A total of 1293 and 203 patients with TB were tested for HIV and MDR-TB in the civilian and penitentiary sectors, respectively.
Of those enrolled for the study, 307 were HIV-positive, 379 had MDR-TB, and 97 had MDR-TB and HIV co-infection. MDR-TB rates in the civilian sector were respectively 15.5% (95%CI 13.1-17.8) and 41.5% (95%CI 36.4-46.5) in newly diagnosed and previously treated TB patients. Among prisoners, MDR-TB rates were 21.8% (95%CI 12.4-31.2) in new cases and 52.8% (95%CI 43.9-61.7) in previously treated TB cases. HIV status was significantly associated with MDR-TB (OR 1.7, 95%CI 1.3-2.3).
High MDR-TB rates and a positive association between MDR-TB and HIV epidemics were found in Donetsk Oblast. Urgent measures to improve HIV prevention, control of drug-resistant TB and collaboration between HIV and TB control activities need to be implemented without further delay.
调查乌克兰顿涅茨克州的抗结核药物耐药率，并探讨人类免疫缺陷病毒（HIV）流行与耐多药结核病（MDR-TB）之间的关联。
邀请在顿涅茨克州所有结核病治疗单位就诊的、连续12个月内新诊断和既往接受过治疗的痰涂片阳性结核病患者参与本研究。分别对1293例 civilian部门和203例监狱部门的结核病患者进行了HIV和MDR-TB检测。
纳入研究的患者中，307例HIV阳性，379例患有MDR-TB，97例同时感染了MDR-TB和HIV。 civilian部门新诊断和既往接受过治疗的结核病患者中，MDR-TB率分别为15.5%（95%CI 13.1-17.8）和41.5%（95%CI 36.4-46.5）。在囚犯中，新发病例的MDR-TB率为21.8%（95%CI 12.4-31.2），既往治疗过的结核病病例中为52.8%（95%CI 43.9-61.7）。HIV状态与MDR-TB显著相关（OR 1.7，95%CI 1.3-2.3）。
顿涅茨克州发现了高MDR-TB率以及MDR-TB与HIV流行之间的正相关关系。需要立即采取紧急措施，加强HIV预防、控制耐药结核病，并促进HIV与结核病防控活动之间的协作。
