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通过医务人员主动提供的HIV检测与咨询服务(PITC)在中国结核病患者中开展的HIV流行率及预测因素研究:一项在中国中南部地区开展的多中心研究

Prevalence and predictors of HIV among Chinese tuberculosis patients by provider-initiated HIV testing and counselling (PITC): a multisite study in South Central of China.

作者信息

Xu Junjie, Tang Weiming, Cheng Shiming, Mahapatra Tanmay, Zhou Lin, Lai Yuji, Jiang Yongjun, Liu Feiying, Zhen Xinan, He Jinge, Zhang Jing, Lu Jinxin, Mahapatra Sanchita, Shang Hong

机构信息

Key Laboratory of AIDS Immunology of National Health and Family Planning Commission Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China ; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.

Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, United States of America.

出版信息

PLoS One. 2014 Feb 21;9(2):e89723. doi: 10.1371/journal.pone.0089723. eCollection 2014.

Abstract

BACKGROUND

Tuberculosis (TB) and HIV are two worldwide public health concerns. Co-infection of these two diseases has been considered to be a major obstacle for the global efforts in reaching the goals for the prevention of HIV and TB.

METHOD

A comprehensive cross-sectional study was conducted to recruit TB patients in three provinces (Guangxi, Henan and Sichuan) of China between April 1 and September 30, 2010.

RESULTS

A total of 1,032 consenting TB patients attended this survey during the study period. Among the participants, 3.30% were HIV positive; about one quarter had opportunistic infections. Nearly half of the participants were 50 years or older, the majority were male and about one third were from minority ethnic groups. After adjusting for site, gender and areas of residence (using the partial/selective Model 1), former commercial plasma donors (adjusted OR [aOR] = 33.71) and injecting drug users(aOR = 15.86) were found to have significantly higher risk of being HIV-positivity. In addition, having extramarital sexual relationship (aOR = 307.16), being engaged in commercial sex (aOR = 252.37), suffering from opportunistic infections in the past six months (aOR = 2.79), losing 10% or more of the body weight in the past six months (aOR = 5.90) and having abnormal chest X-ray findings (aOR = 20.40) were all significantly associated with HIV seropositivity (each p<0.05).

CONCLUSIONS

HIV prevalence among TB patients was high in the study areas of China. To control the dual epidemic, intervention strategies targeting socio-demographic and behavioral factors associated with higher risk of TB-HIV co-infection are urgently called for.

摘要

背景

结核病(TB)和艾滋病毒是两个全球公共卫生问题。这两种疾病的合并感染被认为是全球实现预防艾滋病毒和结核病目标努力的主要障碍。

方法

2010年4月1日至9月30日期间,在中国三个省份(广西、河南和四川)开展了一项全面的横断面研究,以招募结核病患者。

结果

在研究期间,共有1032名同意参与的结核病患者参加了此次调查。在参与者中,3.30%为艾滋病毒阳性;约四分之一的人有机会性感染。近一半的参与者年龄在50岁及以上,大多数为男性,约三分之一来自少数民族。在调整了地点、性别和居住地区(使用部分/选择性模型1)后,发现既往商业血浆捐献者(调整后的比值比[aOR]=33.71)和注射吸毒者(aOR=15.86)感染艾滋病毒阳性的风险显著更高。此外,有婚外性关系(aOR=307.16)、从事商业性行为(aOR=252.37)、在过去六个月内患有机会性感染(aOR=2.79)、在过去六个月内体重减轻10%或更多(aOR=5.90)以及胸部X线检查结果异常(aOR=20.40)均与艾滋病毒血清学阳性显著相关(各p<0.05)。

结论

在中国的研究地区,结核病患者中的艾滋病毒感染率较高。为控制这两种疾病的流行,迫切需要针对与结核病-艾滋病毒合并感染高风险相关的社会人口学和行为因素制定干预策略。

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