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[艾滋病病毒与结核病合并感染情况下抗结核治疗的疗效:刚果民主共和国金沙萨卡宾达中心队列研究]

[Therapeutic outcomes of anti-tuberculosis treatment in the context of HIV-tuberculosis co-infection: Cohort of Kabinda Center in Kinshasa, Democratic Republic of Congo].

作者信息

Akilimali P Z, Tshilumbu J M K, Mavila A K, Kaba D K

机构信息

École de santé publique, université de Kinshasa, PB 11850, Kinshasa, République démocratique du Congo.

École de santé publique, université de Kinshasa, PB 11850, Kinshasa, République démocratique du Congo.

出版信息

Rev Epidemiol Sante Publique. 2015 Dec;63(6):387-93. doi: 10.1016/j.respe.2015.09.007. Epub 2015 Nov 5.

Abstract

BACKGROUND

The study aimed to determine the clinical forms of tuberculosis and therapeutic outcome of anti-tuberculosis treatment in the context of HIV-tuberculosis co-infection.

METHODS

A retrospective cohort of 120 HIV-positive patients with tuberculosis and 297 HIV-negative patients with tuberculosis attending the Kabinda Center was followed from 2010 to June, 30th 2013. The logistic regression model identified the determinants of a defavorable outcome after initiation of tuberculostatics.

RESULTS

The proportion of female patients was higher in the co-infected group compared with the non-co-infected group (60.8% versus 42.7%, P<0.001). HIV-seropositive patients had more forms of pulmonary smear-negative (39.2% versus 25.3%, P<0.002) and extra-pulmonary (38% versus 35%, P<0.002) tuberculosis than HIV-negative patients. HIV-positive serology (OR: 3.13, 95%CI: 1.72-5.69) and age of patients more than 41 years (OR: 3.15, 95%CI: 1.36-7.29) were associated with an unfavorable outcome.

CONCLUSION

This study highlights the usefulness of a systematically determining immunological status in co-infected patients and a timely and systematic ARV treatment, together with early diagnosis of tuberculosis. It also emphasizes the importance of adherence to support measures in order to improve tuberculosis treatment outcomes in co-infected patients.

摘要

背景

本研究旨在确定在艾滋病毒与结核病合并感染情况下结核病的临床类型以及抗结核治疗的疗效。

方法

对2010年至2013年6月30日期间在卡宾达中心就诊的120例艾滋病毒阳性结核病患者和297例艾滋病毒阴性结核病患者进行回顾性队列研究。逻辑回归模型确定了开始抗结核治疗后预后不良的决定因素。

结果

合并感染组女性患者比例高于未合并感染组(60.8%对42.7%,P<0.001)。艾滋病毒血清阳性患者的肺涂片阴性结核病(39.2%对25.3%,P<0.002)和肺外结核病(38%对35%,P<0.002)形式比艾滋病毒阴性患者更多。艾滋病毒阳性血清学(比值比:3.13,95%置信区间:1.72 - 5.69)和年龄超过41岁的患者(比值比:3.15,95%置信区间:1.36 - 7.29)与预后不良相关。

结论

本研究强调了系统确定合并感染患者免疫状态以及及时、系统地进行抗逆转录病毒治疗并早期诊断结核病的有用性。它还强调了坚持支持措施以改善合并感染患者结核病治疗效果的重要性。

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