Santos Danielle Talita Dos, Garcia Maria Concebida, Costa Arlete Alves Nunes Fragoso da, Pieri Flávia Meneguetti, Meier Denise Andrade Pereira, Albanese Silvia Paulino Ribeiro, Arcêncio Ricardo Alexandre, Dessunti Elma Mathias
Escola de Enfermagem de Ribeirao Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Secretaria Municipal de Saúde, Londrina, Brasil.
Cad Saude Publica. 2017 Aug 21;33(8):e00050916. doi: 10.1590/0102-311X00050916.
The study proposed to identify the prevalence of latent tuberculosis infection (LTBI) in persons living with HIV/AIDS (PLWHA), associated factors, and progression to active tuberculosis among the identified cases. This was an epidemiological and descriptive study. The study population consisted of PLWHA seen from 2003 and 2014 in a reference center for HIV/AIDS. Data were collected from patient files and the Brazilian Information System for Notifiable Diseases (SINAN). Bivariate statistical analysis used the chi-square test in which variables with p < 0.2 were selected to enter the multiple regression model. Type I error was set at 5% (p < 0.05) for all the tests. In the study, 690 cases were analyzed, and 66 (9.4%) had a diagnosis of LTBI, with a prevalence of 7.5 cases per 100 patients. Of the 53 cases (80.3%) of LTBI who were prescribed treatment with isoniazid, only 26 (39.4%) concluded treatment, and 10 (15.1%) dropped out. Male gender (adjusted OR = 1.8; 95%CI: 1.1-3.3), current incarceration (adjusted OR = 7.6; 95%CI: 2.35-24.9), and high lymphocyte count were associated with LTBI diagnosis (adjusted OR = 1.1; 95%CI: 1.1-1.2). Forty-seven (6.7%) of LTBI cases progressed to active TB. Diagnosis and treatment of LTBI in PLWHA were not prioritized, which contributed to the development of active disease among cases. The study contributed to knowledge on LTBI in PLWHA, demonstrating crucial aspects in the management of PLWHA and the importance of detecting LTBI and early initiation of isoniazid, aimed at improved quality of life and prognosis for PLWHA.
该研究旨在确定艾滋病毒/艾滋病感染者（PLWHA）中潜伏性结核感染（LTBI）的患病率、相关因素以及确诊病例中进展为活动性结核病的情况。这是一项流行病学描述性研究。研究人群包括2003年至2014年在一家艾滋病毒/艾滋病参考中心就诊的PLWHA。数据从患者档案和巴西法定传染病信息系统（SINAN）收集。双变量统计分析采用卡方检验，其中p<0.2的变量被选入多元回归模型。所有检验的I型错误设定为5%（p<0.05）。在该研究中，分析了690例病例，其中66例（9.4%）被诊断为LTBI，患病率为每100例患者中有7.5例。在53例（80.3%）接受异烟肼治疗的LTBI病例中，只有26例（39.4%）完成治疗，10例（15.1%）退出治疗。男性（调整后的OR=1.8；95%CI：1.1-3.3）、当前被监禁（调整后的OR=7.6；95%CI：2.35-24.9）以及淋巴细胞计数高与LTBI诊断相关（调整后的OR=1.1；95%CI：1.1-1.2）。47例（6.7%）LTBI病例进展为活动性结核病。PLWHA中LTBI的诊断和治疗未得到优先重视，这导致病例中出现活动性疾病。该研究有助于了解PLWHA中的LTBI，展示了PLWHA管理中的关键方面以及检测LTBI和早期开始使用异烟肼的重要性，旨在改善PLWHA的生活质量和预后。
