Colebunders R L, Ryder R W, Nzilambi N, Dikilu K, Willame J C, Kaboto M, Bagala N, Jeugmans J, Muepu K, Francis H L
Project SIDA, Department of Public Health, Belgian Zairian Medical Cooperation, Kinshasa.
Am Rev Respir Dis. 1989 May;139(5):1082-5. doi: 10.1164/ajrccm/139.5.1082.
To better define the interrelationship of infection with human immunodeficiency virus (HIV) and tuberculosis (TB), we conducted three HIV serosurveys of inpatients and outpatients with confirmed or suspected TB in Kinshasa, Zaire. HIV seroprevalence in hospitalized sanatorium patients did not change significantly in serosurveys conducted in 1985 and 1987 (92/231 [40%] versus 85/234 [36%]). These proportions were significantly higher than the 17% HIV seroprevalence observed in a 1987 serosurvey of 509 consecutive patients with an initial diagnosis of pulmonary TB seen at an outpatient TB diagnostic center in Kinshasa (p less than 0.001). HIV seroprevalence was higher in sanatorium patients with extrapulmonary TB (22/46 [48%]) and suspected pulmonary TB (60/132 [45%]) than in patients with bacteriologically confirmed pulmonary TB (94/287 [33%]) (p less than 0.02). Mycobacterium sputum isolation rates were similar in HIV-seropositive (28/34 [82%]) and HIV-seronegative patients (135/159 [85%]). All isolates were Mycobacterium tuberculosis. Eighteen (21%) of 84 HIV-seropositive sanatorium patients in 1987, who were followed for two months after admission, had died, compared with 11 (9%) of 128 HIV-seronegative patients (p less than 0.01). However, clearance rates of acid-fast bacilli from sputum after standard therapy were equally good in HIV-seropositive and HIV-seronegative survivors. With the growing AIDS problem, the serious TB burden in sub-Saharan Africa may become even more onerous and may critically overload the stressed African health care systems.
为了更好地明确人类免疫缺陷病毒（HIV）感染与结核病（TB）之间的相互关系，我们在扎伊尔金沙萨对确诊或疑似结核病的住院患者和门诊患者进行了三次HIV血清学调查。1985年和1987年对住院疗养院患者进行的血清学调查中，HIV血清阳性率没有显著变化（92/231 [40%] 对85/234 [36%]）。这些比例显著高于1987年在金沙萨一家门诊结核病诊断中心对509例初诊为肺结核的连续患者进行的血清学调查中观察到的17%的HIV血清阳性率（p<0.001）。疗养院肺外结核患者（22/46 [48%]）和疑似肺结核患者（60/132 [45%]）的HIV血清阳性率高于细菌学确诊肺结核患者（94/287 [33%]）（p<0.02）。HIV血清阳性患者（28/34 [82%]）和HIV血清阴性患者（135/159 [85%]）的痰液分枝杆菌分离率相似。所有分离株均为结核分枝杆菌。1987年，84例HIV血清阳性的疗养院患者中，有18例（21%）在入院后随访两个月时死亡，而128例HIV血清阴性患者中有11例（9%）死亡（p<0.01）。然而，在标准治疗后，HIV血清阳性和HIV血清阴性幸存者痰液中抗酸杆菌的清除率同样良好。随着艾滋病问题的日益严重，撒哈拉以南非洲严重的结核病负担可能会变得更加沉重，并可能严重压垮不堪重负的非洲医疗保健系统。
