Iliyasu Zubairu, Babashani Musa
Departments of Community Medicine, Aminu Kano Teaching Hospital and Bayero University, Kano, Nigeria.
J Epidemiol. 2009;19(2):81-7. doi: 10.2188/jea.je20080026. Epub 2009 Mar 6.
The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians.
The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed.
A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41-50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28-3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42-8.34; P = 0.001), and baseline CD4 count (2.71; 1.51-6.21; P = 0.02) remained significant predictors after adjustment for confounding.
The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB.
尽管合并感染的患病率在很大程度上尚不清楚，尤其是在包括尼日利亚在内的发展中国家，但艾滋病病毒/艾滋病流行一直伴随着严重的结核病（TB）流行。本研究的目的是确定尼日利亚艾滋病毒血清阳性者中结核病合并感染的患病率及预测因素。
回顾了2006年1月至12月在尼日利亚阿明努·卡诺教学医院就诊的艾滋病病毒/艾滋病患者的病历。
共有1320例艾滋病病毒/艾滋病患者有完整记录并接受了回顾，其中138例（10.5%）合并感染结核病（95%可信区间，8.9%至12.2%）。103例（74.6%）患者被诊断为肺结核，其中只有18例（17.5%）痰菌阳性。50例（36.2%）合并感染患者患有某种肺外结核（EPTB）；15例同时患有肺结核和EPTB。仅在35例EPTB患者中，20例（57.1%）患有腹部结核，5例（14.3%）患有结核性腺炎，5例（14.3%）患有脊柱结核，3例（8.6%）正在接受结核性脑膜炎监测，1例（2.9%）分别患有肾结核和结核性肾上腺炎。结核病患病率最高的是41至50岁的患者，为13.7%（n = 28）。结核病合并感染与婚姻状况、世界卫生组织临床分期和CD4细胞计数显著相关。在调整混杂因素后，婚姻状况（比值比，2.1；95%可信区间，1.28至3.59；P = 0.04）、就诊时的世界卫生组织临床分期（4.81；1.42至8.34；P = 0.001）和基线CD4细胞计数（2.71；1.51至6.21；P = 0.02）仍然是显著的预测因素。
艾滋病毒血清阳性患者中结核病患病率中等偏高，这突出表明迫切需要采取策略，以便快速识别并治疗活动性或潜伏性结核病合并感染。
