Bridge Consultants Foundation,Karachi,Pakistan.
BMJ Open. 2012 Oct 18;2(5). doi: 10.1136/bmjopen-2012-001677. Print 2012.
To describe feasibility and results of systematic screening of tuberculosis (TB) patients for HIV.
Cross-sectional study.
Six selected sentinel sites (public DOTS clinics) in the province of Sindh, Pakistan.
All TB patients aged 16-60 years registered for treatment from April 2008 to March 2012.
Demographic information of registered TB patients, screening for HIV through rapid testing and confirmation by referral lab of Sindh AIDS Control Program, according to national guidelines.
Of a total of 18 461 registered TB patients, 12 882 fulfilled the inclusion criteria and were given education and counselling. Of those counselled 12 552 (97.4%) were screened for HIV using a rapid test. Men made up 48% of the sample and 76.5% of patients had pulmonary TB. Of the total patients tested, 42 (0.34%) were HIV-positive after confirmatory testing at the Sindh AIDS Control Program Laboratory. Prevalence of HIV among male patients was 0.67% whereas prevalence among female patients was 0.03% (p value <0.001). Prevalence of HIV among pulmonary TB patients was 0.29% and among extrapulmonary TB patients was 0.48% (p value=0.09).
In public DOTS clinics in Pakistan it is feasible to test TB patients for HIV. Prevalence of HIV is three times higher among TB patients as compared with the general population in Pakistan. Although the results are not representative of Pakistan or Sindh province they cover a large catchment area and closely match WHO estimate for the country. Routinely screening all TB patients for HIV infection, especially targeting men and ensuring antiretroviral therapy, can significantly improve TB/HIV collaborative activities in Pakistan and identify many cases of HIV, improve health outcomes and save lives.
描述对结核病（TB）患者进行艾滋病毒（HIV）系统筛查的可行性和结果。
横断面研究。
巴基斯坦信德省六个选定的哨点（公共直接督导下的短程化疗诊所）。
2008 年 4 月至 2012 年 3 月期间登记接受治疗的所有年龄在 16-60 岁的结核病患者。
登记的结核病患者的人口统计学信息，通过快速检测筛查 HIV，并根据国家指南由信德艾滋病控制项目的参考实验室确认。
在总共登记的 18461 例结核病患者中，有 12882 例符合纳入标准并接受了教育和咨询。在接受咨询的患者中，有 12552 例（97.4%）接受了 HIV 快速检测。该样本中男性占 48%，76.5%的患者患有肺结核。在接受检测的总患者中，有 42 例（0.34%）在信德艾滋病控制项目实验室进行确认检测后呈 HIV 阳性。男性患者中 HIV 的患病率为 0.67%，而女性患者中 HIV 的患病率为 0.03%（p 值<0.001）。肺结核患者中 HIV 的患病率为 0.29%，肺外结核患者中 HIV 的患病率为 0.48%（p 值=0.09）。
在巴基斯坦的公共 DOTS 诊所中，对结核病患者进行 HIV 检测是可行的。结核病患者中 HIV 的患病率是巴基斯坦一般人群的三倍。尽管这些结果不能代表巴基斯坦或信德省，但它们覆盖了一个很大的流域，与世界卫生组织对该国的估计非常吻合。对所有结核病患者常规筛查 HIV 感染，特别是针对男性并确保提供抗逆转录病毒治疗，可以显著改善巴基斯坦的结核病/艾滋病合作活动，并发现许多 HIV 病例，改善健康结局并拯救生命。
