Ford Nathan, Matteelli Alberto, Shubber Zara, Hermans Sabine, Meintjes Graeme, Grinsztejn Beatriz, Waldrop Greer, Kranzer Katharina, Doherty Meg, Getahun Haileyesus
Department of HIV, World Health Organization, Geneva, Switzerland;
Global TB Programme, World Health Organization, Geneva, Switzerland.
J Int AIDS Soc. 2016 Jan 12;19(1):20714. doi: 10.7448/IAS.19.1.20714. eCollection 2016.
Despite significant progress in improving access to antiretroviral therapy over the past decade, substantial numbers of people living with HIV (PLHIV) in all regions continue to experience severe illness and require hospitalization. We undertook a global review assessing the proportion of hospitalizations and in-hospital deaths because of tuberculosis (TB) in PLHIV.
Seven databases were searched to identify studies reporting causes of hospitalizations among PLHIV from 1 January 2007 to 31 January 2015 irrespective of age, geographical region or language. The proportion of hospitalizations and in-hospital mortality attributable to TB was estimated using random effects meta-analysis.
From an initial screen of 9049 records, 66 studies were identified, providing data on 35,845 adults and 2792 children across 42 countries. Overall, 17.7% (95% CI 16.0 to 20.2%) of all adult hospitalizations were because of TB, making it the leading cause of hospitalization overall; the proportion of adult hospitalizations because of TB exceeded 10% in all regions except the European region. Of all paediatric hospitalizations, 10.8% (95% CI 7.6 to 13.9%) were because of TB. There was insufficient data among children for analysis by region. In-hospital mortality attributable to TB was 24.9% (95% CI 19.0 to 30.8%) among adults and 30.1% (95% CI 11.2 to 48.9%) among children.
TB remains a leading cause of hospitalization and in-hospital death among adults and children living with HIV worldwide.
尽管在过去十年中，在改善抗逆转录病毒疗法的可及性方面取得了重大进展，但所有地区仍有大量艾滋病毒感染者（PLHIV）罹患重病并需要住院治疗。我们进行了一项全球综述，评估艾滋病毒感染者中因结核病（TB）住院和院内死亡的比例。
检索了七个数据库，以确定报告2007年1月1日至2015年1月31日期间艾滋病毒感染者住院原因的研究，不受年龄、地理区域或语言限制。使用随机效应荟萃分析估计因结核病导致的住院和院内死亡率。
从对9049条记录的初步筛选中，确定了66项研究，提供了来自42个国家的35845名成人和2792名儿童的数据。总体而言，所有成人住院病例中有17.7%（95%置信区间16.0至20.2%）是因结核病，使其成为总体住院的主要原因；除欧洲区域外，所有地区因结核病导致的成人住院比例均超过10%。在所有儿科住院病例中，10.8%（95%置信区间7.6至13.9%）是因结核病。儿童中按地区分析的数据不足。成人中因结核病导致的院内死亡率为24.9%（95%置信区间19.0至30.8%），儿童中为30.1%（95%置信区间11.2至48.9%）。
结核病仍然是全球艾滋病毒感染成人和儿童住院和院内死亡的主要原因。
