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[中国结核分枝杆菌与HIV/AIDS合并感染的Meta分析]

[Meta analysis on the co-infection between Mycobacterium tuberculosis and HIV/AIDS in China].

作者信息

Liu Jiao, Lü Bing, Yan Yan

机构信息

Department of Epidemiology and Health Statistics, Public Health of Central South University, Changsha, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2013 Jan;34(1):85-90.

Abstract

OBJECTIVE

To understand and estimate the rate of co-infection between Mycobacterium tuberculosis (M. tuberculosis) and the human immunodeficiency virus (HIV).

METHODS

Based on the related literature regarding Chinese M. tuberculosis and HIV co-infection being published between 2000 and 2012 in PubMed, China National Knowledge Infrastructure (CNKI), Wan Fang Databases and the Chinese Science & Technology Journal Database (VIP), we extracted related information and applied the generic inverse variance model to estimate the following parameters as: co-infection rate, differences on gender, region and subgroups. We also used the STROBE Statement and observational quality evaluation standard to evaluate the quality of literature, and employed sensitivity analyses to evaluate the impact of research quality.

RESULTS

39 papers were included in this Meta-analysis, which contained a total sample size of 168 286. The co-infection rate of HIV in TB patients was 0.86% (95%CI: 0.80% - 0.93%), when using the generic inverse variance model. According to subgroups analyses, at α = 0.05 level, men had a higher co-infection rate (1.53%) than women (0.54%) and areas with high infection rate of HIV/AIDS (0.91%) were more commonly seen than low infection rate areas of HIV/AIDS (0.71%) and with significant differences. The co-infection rate of M. tuberculosis in patients infected with HIV was 14.44% (95%CI: 13.62% - 15.30%). Data from subgroup analyses also showed that at the α = 0.05 level, the co-infection rates from hospital samples (28.64%) were higher than those from the population samples' (4.74%). The co-infection rate (15.79%) from the western region was higher than that in the Central and Eastern regions (13.88% and 6.47% respectively), with significant differences. After excluding the papers that only met a few items of the STRODE Statement, results of the Meta-analysis were very close to the original results.

CONCLUSION

The co-infection rate of both M. tuberculosis and HIV was high in China. Therefore, it was crucial for people and related organizations to pay more attention to this problem of co-infection.

摘要

目的

了解并估计结核分枝杆菌(M. tuberculosis)与人类免疫缺陷病毒(HIV)的合并感染率。

方法

基于2000年至2012年间发表于PubMed、中国知网(CNKI)、万方数据库及维普中文科技期刊数据库(VIP)中有关中国M. tuberculosis与HIV合并感染的相关文献,我们提取相关信息并应用通用逆方差模型来估计以下参数:合并感染率、性别差异、地区差异及亚组差异。我们还使用了STROBE声明和观察性研究质量评价标准来评估文献质量,并采用敏感性分析来评估研究质量的影响。

结果

本Meta分析纳入39篇论文,样本总量为168286例。采用通用逆方差模型时,结核病患者中HIV的合并感染率为0.86%(95%CI:0.80% - 0.93%)。亚组分析显示,在α = 0.05水平上,男性的合并感染率(1.53%)高于女性(0.54%),且艾滋病病毒/艾滋病高感染率地区(0.91%)的合并感染率高于低感染率地区(0.71%),差异有统计学意义。HIV感染者中M. tuberculosis的合并感染率为14.44%(95%CI:13.62% - 15.30%)。亚组分析数据还显示,在α = 0.05水平上,医院样本的合并感染率(28.64%)高于人群样本(4.74%)。西部地区的合并感染率(15.79%)高于中部和东部地区(分别为13.88%和6.47%),差异有统计学意义。排除仅符合STRODE声明少数条目的论文后,Meta分析结果与原始结果非常接近。

结论

中国M. tuberculosis与HIV的合并感染率较高。因此,个人及相关组织应更加关注这一合并感染问题,这至关重要。

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