Maimaiti Rena, Zhang Yuexin, Pan Kejun, Mijiti Peierdun, Wubili Maimaitiali, Musa Maimaitijiang, Andersson Rune
Department of Prevention and Health Care, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Department of Infection Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
BMC Infect Dis. 2017 Jan 5;17(1):15. doi: 10.1186/s12879-016-2152-4.
Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang.
In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis.
The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001).
The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.
结核病和艾滋病病毒共同流行是世界许多地区面临的问题。新疆是中国结核病和艾滋病病毒高流行地区。我们旨在调查新疆艾滋病病毒阳性患者中结核病的患病率和治愈率。
在一项2006年至2011年的回顾性研究中，将333例艾滋病病毒和结核病患者的临床和实验室数据与2668例仅感染艾滋病病毒的患者进行了比较。有31例艾滋病病毒阳性患者没有结核病数据。
艾滋病病毒阳性患者中结核病合并感染的患病率为11%（95%可信区间10%-12%），显著高于中国全国2%的水平。在大多数情况下，艾滋病病毒诊断较晚，免疫缺陷严重。符合接受异烟肼预防性治疗标准的未患结核病患者中异烟肼预防性治疗的使用率仅为57.9%。诊断后一年的治愈率为69.2%，低于2011年新疆所有结核病病例官方报告的91.4%。在调整性别和静脉吸毒因素后，艾滋病病毒合并结核病患者五年内死亡风险显著高于仅感染艾滋病病毒的患者，风险比为1.84（95%可信区间1.43-2.35；p<0.0001）。
新疆艾滋病病毒阳性患者中结核病的患病率高于全国整体水平；艾滋病病毒诊断较晚；异烟肼预防性治疗使用不足。治愈率低和生存率降低可能归因于艾滋病病毒诊断延迟、未进行抗生素耐药性检测以及对结核病和艾滋病病毒治疗方案依从性控制不足。
