Department of HIV and STI, Health Protection Agency, Health Protection Services, London, UK.
AIDS. 2013 Apr 24;27(7):1151-7. doi: 10.1097/QAD.0b013e32835e2cb1.
To calculate annual tuberculosis incidence rates, and investigate risk factors for tuberculosis, among heterosexual adults living with diagnosed HIV in England and Wales.
Analyses of comprehensive national records of persons seen for HIV care between 2002 and 2010 linked to the national tuberculosis database (1999-2010) for England and Wales.
Annual incidence rates of tuberculosis among heterosexual adults living with diagnosed HIV were calculated on the basis of the number of heterosexual adults seen for HIV care in a given year and the number, in that same year, with a first episode of tuberculosis at the time of, or subsequent to, their HIV diagnosis.
Between 2002 and 2010, almost one in 10 (4266/45,322) heterosexual adults living with HIV were diagnosed with tuberculosis, of whom the majority (92%) were diagnosed at the time of, or after, their HIV diagnosis; 84% (3307) were black African. The annual tuberculosis incidence rate decreased from 30 per 1000 in 2002 to 8.8 per 1000 in 2010 (P < 0.01). The annual tuberculosis incidence rate among those not on antiretroviral therapy (ART) was significantly higher than among those using ART (2010: 36 versus 3 per 1000; P < 0.01).
The annual tuberculosis incidence rate among heterosexual adults living with diagnosed HIV in England and Wales has declined significantly over the past decade. However, the 2010 rate remains significantly higher than in the general population. Our findings support routine HIV testing in tuberculosis clinics, screening for latent tuberculosis in HIV diagnosed persons, and the prompt initiation of ART where appropriate.
计算在英格兰和威尔士，确诊感染 HIV 的异性恋成年人中，每年结核病发病率，并调查结核病发病的风险因素。
对 2002 年至 2010 年间在艾滋病毒护理机构就诊的人群进行全面国家记录分析，并与英格兰和威尔士的全国结核病数据库（1999-2010 年）进行了链接。
根据特定年份就诊的异性恋成年人数量以及该年诊断 HIV 时或之后初次发生结核病的数量，计算出诊断 HIV 的异性恋成年人中每年结核病的发病率。
在 2002 年至 2010 年间，45322 名诊断 HIV 的异性恋成年人中，近十分之一（4266 人）被诊断患有结核病，其中大多数（92%）在诊断 HIV 时或之后被诊断患有结核病；84%（3307 人）是黑非洲人。结核病年发病率从 2002 年的 30/1000 下降到 2010 年的 8.8/1000（P < 0.01）。未接受抗逆转录病毒疗法（ART）的患者的年结核病发病率明显高于接受 ART 的患者（2010 年：36 比 3/1000；P < 0.01）。
在过去十年中，英格兰和威尔士确诊感染 HIV 的异性恋成年人的年结核病发病率显著下降。然而，2010 年的发病率仍明显高于普通人群。我们的研究结果支持在结核病诊所进行常规 HIV 检测，对诊断为 HIV 的人群进行潜伏性结核病筛查，并在适当情况下及时开始进行 ART。
