Ligidi Tadesse, Gebre-Selassie Solomon, Tsegaye Aster
Department of Bacteriology and Parasitology, Adama Regional Laboratory, Adama, Ethiopia.
Ethiop Med J. 2011 Apr;49(2):75-83.
Tuberculosis remains a public health problem in patients with human immunodeficiency virus infection in sub-Saharan Africa. Both diseases form a lethal combination, each speeding the progress of the other.
The aim of this study was to assess the prevalence of HIV infection in newly diagnosed tuberculosis patients in Adama hospital.
Blood and sputum samples were collected from adult newly diagnosed tuberculosis patients. Sera were screened for anti-HIV antibody using rapid HIV test kits based on the National testing algorithm. The CD4 and CD8 T-cell subsets were determined using flow cytometry and the ratio of CD4+ and CD8+ were estimated using FACScan. All sputum specimens collected on three consecutive days from patients attending the tuberculosis clinic were screened for acid fast bacilli using smear microscopy.
The seroprevalence of HIV among 258 patients with newly diagnosed TB was 26.4%. The median CD4 T cell count of HIV negative and HIV positive TB patients were 702 cells/mm3 and 233 cells/mm3. respectively (P < 0.05). Of the TB patients, 35.7% had extrapulmonary TB and 20% were smear-positive pulmonary TB. The CD4/CD8 ratio in HIV negative patients was 1.33 cells/mm3 compared to the 0.29 cells/mm3 in HIV positive patients. Of the 68 HIV positive TB patients. 58(85.3%) were not aware of their HIV serostatus prior to the screening in the current study.
In the current study the HIV seroprevalence was 26.4%. The median CD4 count was very low in the TB/HIV co-infected individuals than those infected with TB alone. Majority of the HIV infected individuals were not aware of their serostatus. Provider initiated HIV/AIDS counseling and testing in TB clinics should be strengthened
在撒哈拉以南非洲地区，结核病仍然是人类免疫缺陷病毒感染患者面临的一个公共卫生问题。这两种疾病形成了致命组合，彼此加速对方的进展。
本研究旨在评估阿达马医院新诊断结核病患者中艾滋病毒感染的患病率。
从新诊断的成年结核病患者中采集血液和痰液样本。根据国家检测算法，使用快速艾滋病毒检测试剂盒对血清进行抗艾滋病毒抗体筛查。使用流式细胞术测定CD4和CD8 T细胞亚群，并使用FACScan估计CD4+和CD8+的比例。对在结核病门诊连续三天就诊的患者采集的所有痰液标本进行涂片显微镜检查，以筛查抗酸杆菌。
258例新诊断结核病患者中艾滋病毒血清阳性率为26.4%。艾滋病毒阴性和艾滋病毒阳性结核病患者的CD4 T细胞计数中位数分别为702个细胞/立方毫米和233个细胞/立方毫米（P<0.05）。在结核病患者中，35.7%患有肺外结核，20%为涂片阳性肺结核。艾滋病毒阴性患者的CD4/CD8比值为1.33个细胞/立方毫米，而艾滋病毒阳性患者为0.29个细胞/立方毫米。在68例艾滋病毒阳性结核病患者中，58例（85.3%）在本研究筛查前不知道自己的艾滋病毒血清状态。
在本研究中，艾滋病毒血清阳性率为26.4%。结核病/艾滋病毒合并感染个体的CD4计数中位数比单纯感染结核病的个体低得多。大多数艾滋病毒感染者不知道自己的血清状态。应加强在结核病诊所由医疗服务提供者发起的艾滋病毒/艾滋病咨询和检测。
