Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
BMC Pulm Med. 2011 May 23;11:26. doi: 10.1186/1471-2466-11-26.
Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods.
We included patients from a population-based, multicenter, nationwide cohort. We calculated incidence rates (IRs) and mortality rates (MRs). Cox's regression analysis was used to estimate risk factors for TB infection with HAART initiation included as time updated variable. Kaplan-Meier was used to estimate mortality after TB.
Among 2,668 patients identified, 120 patients developed TB during the follow-up period. The overall IR was 8.2 cases of TB/1,000 person-years of follow-up (PYR). IRs decreased during the pre-, early and late-HAART periods (37.1/1000 PYR, 12.9/1000 PYR and 6.5/1000 PYR respectively). African and Asian origin, low CD4 cell count and heterosexual and injection drug user route of HIV transmission were risk factors for TB and start of HAART reduced the risk substantially. The overall MR in TB patients was 34.4 deaths per 1,000 PYR (95% Confidence Interval: 22.0-54.0) and was highest in the first two years after the diagnosis of TB.
Incidence of TB still associated with conventional risk factors as country of birth, low CD4 count and route of HIV infection while HAART reduces the risk substantially. The mortality in this patient population is high in the first two years after TB diagnosis.
人类免疫缺陷病毒（HIV）感染可导致结核病（TB）。我们描述了在 HIV-1 感染患者中，在预（1995-1996 年）、早（1997-1999 年）和晚（2000-2007 年）高效抗逆转录病毒治疗（HAART）时期，TB 的发病率、危险因素和预后。
我们纳入了来自基于人群的、多中心、全国性队列的患者。我们计算了发病率（IR）和死亡率（MR）。Cox 回归分析用于估计随着 HAART 开始而作为时间更新变量的 TB 感染的危险因素。Kaplan-Meier 用于估计 TB 后的死亡率。
在确定的 2668 名患者中，120 名患者在随访期间发生了 TB。总的 IR 为每 1000 人年随访（PYR）8.2 例 TB。IR 在预、早和晚 HAART 期间下降（分别为 37.1/1000 PYR、12.9/1000 PYR 和 6.5/1000 PYR）。非洲和亚洲血统、低 CD4 细胞计数以及异性恋和注射吸毒者传播 HIV 的途径是 TB 和 HAART 开始的危险因素。TB 患者的总体 MR 为每 1000 PYR 34.4 例死亡（95%置信区间：22.0-54.0），在 TB 诊断后的头两年最高。
TB 的发病率仍与出生国家、低 CD4 计数和 HIV 感染途径等传统危险因素相关，而 HAART 大大降低了风险。在 TB 诊断后的头两年，该患者人群的死亡率很高。
