[Effect of antiretroviral therapy in reducing deaths among patients co-infected with Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi].

OBJECTIVE

To understand the effect of antiretroviral therapy (ART) in reducing deaths among patients co-infected with Mycobacterium tuberculosis and human immunodeficiency virus (TB/HIV), and provide data-based evidence for improving ART in TB/HIV patients.

METHODS

The information about TB patients who were HIV positive confirmed previously or recently in Guangxi were collected, and the TB/HIV patients were confirmed by using the related data from national AIDS prevention and treatment information system. Then a retrospective case control study was conducted to understand the survivals and deaths in the patients receiving ART or receiving no ART by using Kaplan-Meier method and estimate the ART protective rate within 1 year after TB treatment initiation.

RESULTS

Among 519 TB/HIV patients, 100 received ART (19.3%); Among 84 TB/HIV patients who died within 1 year after TB treatment, 8 (9.5%) received ART, while 76 (90.5%) received no ART. Compared with the 18.7% mortality rate in non-ART group, TB/HIV patients mortality rate in ART group was only 8.08%, the difference was statistical significant (P < 0.05). Kaplan-Meier survival curve showed that the survival rate in patients receiving ART was higher than that in patients receiving no ART within 1 year after TB treatment, the difference was statistical significant (Log-rank = 4.96, P = 0.02). Compared with patients receiving ART, the OR value was 2.31 times higher than that in patients receiving no ART;ART could protect 56.7% of TB/HIV patients against death during the first year of anti-TB therapy.

CONCLUSION

In the first year of anti-TB therapy, the risk of death in TB/HIV patients receiving no ART was much higher than that in TB/HIV patients receiving ART, and the survival time was longer in the patients receiving ART. The ART coverage should be expanded in TB/HIV patients.