Simieneh Asnake, Hailemariam Mengistu, Amsalu Anteneh
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Ethiopia.
Department of Medical Microbiology, University of Gondar, Ethiopia.
Pan Afr Med J. 2017 Sep 26;28:75. doi: 10.11604/pamj.2017.28.75.11977. eCollection 2017.
Initiation of antiretroviral therapy (ART) and co-trimoxazole preventive therapy (CPT) is recommended for tuberculosis (TB)/human immunodeficiency virus (HIV) co-infected patients to prevent opportunistic infection. The aim of this study was to assess the prevalence of HIV among TB patients and initiation of ART and provision of CPT for TB/HIV co-infected patients in Hawassa university referral hospital.
A five year document review was done on 1961 TB patients who are registered at TB clinic of Hawassa university referral hospital from September 2009 to august 2014. Data were collected using checklist. Data analysis was done by using SPSS version 20 software. Bivariate and multivariate logistic regression analysis was used to determine the predictors of TB/HIV co-infection.
Among 1961 TB patients diagnosed in the hospital, 95% (1765) were screened for HIV. Of these, 13.9% (246) were HIV positive. Out of 246 TB/HIV co-infected patients 31.7% (78/246) and 37.4% (92/246) were enrolled to start ART and CPT respectively. Roughly the trends of TB/HIV co-infection decreased with increased linkage to CPT, while linkage to ART was not regular across the year. The rate of TB/HIV co-infection was significantly associated with type of TB.
Although, trend of HIV among TB patients has decreased across the year, only a minority of co-infected patients was linked to start ART and CPT. Therefore, screening of all TB patients for HIV and linkage of co-infected patients to HIV care to start ART and CPT should be strengthened in-line with the national guidelines.
对于结核病（TB）/人类免疫缺陷病毒（HIV）合并感染的患者，建议启动抗逆转录病毒疗法（ART）和复方新诺明预防性疗法（CPT）以预防机会性感染。本研究的目的是评估在哈瓦萨大学转诊医院中，结核病患者的HIV感染率，以及为TB/HIV合并感染患者启动ART和提供CPT的情况。
对2009年9月至2014年8月在哈瓦萨大学转诊医院结核病门诊登记的1961例结核病患者进行了为期五年的文档回顾。使用检查表收集数据。采用SPSS 20版软件进行数据分析。采用双变量和多变量逻辑回归分析来确定TB/HIV合并感染的预测因素。
在该医院诊断的1961例结核病患者中，95%（1765例）接受了HIV筛查。其中，13.9%（246例）为HIV阳性。在246例TB/HIV合并感染患者中，分别有31.7%（78/246）和37.4%（92/246）登记开始接受ART和CPT治疗。大致上，TB/HIV合并感染的趋势随着CPT关联率的增加而下降，而ART的关联在全年并不规律。TB/HIV合并感染率与结核病类型显著相关。
尽管全年结核病患者中的HIV感染趋势有所下降，但只有少数合并感染患者接受了ART和CPT治疗。因此，应按照国家指南加强对所有结核病患者进行HIV筛查，并将合并感染患者与HIV治疗相联系，以启动ART和CPT治疗。
