2008 - 2010年越南HIV感染患者中异烟肼预防性治疗试点项目的实施与评估

Implementation and evaluation of an isoniazid preventive therapy pilot program among HIV-infected patients in Vietnam, 2008-2010.

作者信息

Trinh Thuy T, Han Dien T, Bloss Emily, Le Thai H, Vu Tung T, Mai Anh H, Nguyen Nhung V, Nguyen Long T, Dinh Sy N, Whitehead Sara

机构信息

U.S. Centers for Disease Control and Prevention, US Embassy, 7 Lang Ha street, Hanoi, Vietnam

Vietnam National TB Program, 463 Hoang Hoa Tham, Hanoi, Vietnam.

出版信息

Trans R Soc Trop Med Hyg. 2015 Oct;109(10):653-9. doi: 10.1093/trstmh/trv074.

DOI:10.1093/trstmh/trv074

PMID:26385936

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4797995/

Abstract

BACKGROUND

WHO recommends screening for TB and evaluation for isoniazid preventive therapy (IPT) based on evidence that they reduce TB-related morbidity and mortality among HIV-infected persons. In Vietnam, an IPT pilot was implemented in two provinces; TB screening, treatment and outcomes were evaluated to inform the adoption and scale-up of IPT.

METHODS

During April 2008 to March 2010, eligible HIV-infected persons aged >15 years, with no previous or current TB treatment, alcohol abuse or liver disease were screened for TB. If TB disease was ruled out based on symptoms, chest x-rays and sputum smears, isoniazid was administered for 9 months.

RESULTS

Among 1281 HIV-infected persons who received initial eligibility screening, 520 were referred to and evaluated at district TB clinics for TB disease or IPT eligibility. Active TB was diagnosed in 17 patients and all were started on treatment. Of 520 patients evaluated, 416 (80.0%) initiated IPT: 382 (91.8%) completed IPT, 17 (4.1%) stopped treatment, 8 (1.9%) died, 3 (0.7%) developed TB during IPT and 6 (1.4%) had unknown outcomes. No severe adverse events were reported.

CONCLUSIONS

IPT treatment completion was high; no serious complications occurred. Improving and expanding intensified case-finding and IPT should be considered in Vietnam.

摘要

背景

世界卫生组织建议基于结核病筛查及异烟肼预防性治疗（IPT）可降低HIV感染者中与结核病相关的发病率和死亡率这一证据，开展结核病筛查及IPT评估。在越南，在两个省份实施了IPT试点项目；对结核病筛查、治疗及结果进行评估，以为IPT的采用和扩大规模提供依据。

方法

在2008年4月至2010年3月期间，对年龄超过15岁、既往未接受过结核病治疗且目前无结核病、无酗酒或肝病的符合条件的HIV感染者进行结核病筛查。如果根据症状、胸部X光片和痰涂片排除了结核病，则给予异烟肼治疗9个月。

结果

在1281名接受初始资格筛查的HIV感染者中，有520人被转诊至地区结核病诊所，以评估是否患有结核病或是否符合IPT资格。17名患者被诊断为活动性结核病，均开始接受治疗。在接受评估的520名患者中，416名（80.0%）开始接受IPT：382名（91.8%）完成了IPT，17名（4.1%）停止治疗，8名（1.9%）死亡，3名（0.7%）在IPT期间患结核病，6名（1.4%）结局不明。未报告严重不良事件。