Ka D, Ngom Guéye N F, Fall N, Touré-Badiane N O, Diop N, Batista G, Ndiaye K, Ndour C T, Seydi M, Faye M A
Université Cheikh Anta Diop de Dakar, Service des maladies infectieuses et tropicales, CNHU Fann, 5035 Dakar, Sénégal.
Université Alioune Diop de Bambey, Sénégal.
Med Sante Trop. 2017 Nov 1;27(4):392-396. doi: 10.1684/mst.2017.0717.
To determine the prevalence of tuberculosis and describe its epidemiological, clinical, paraclinical, and therapeutic characteristics and its outcome in patients with HIV. This retrospective, descriptive, and analytical study examined the records of patients with HIV at our outpatient treatment center and selected those who were antiretroviral-naive and presented tuberculosis between January 2008 and December 2012. Among a total of 757 HIV-positive patients, 76 had tuberculosis, for a prevalence of 10 %. The sex ratio of 1.23 favored men. The average age was 42.5 years (range: 25 to 69 years. Nearly all these patients (71 cases) had HIV-1. A history of tuberculosis was reported by 39.5 %. Seventeen patients were malnourished. Management included chemoprophylaxis with cotrimoxazole for 64 patients. The pulmonary form predominated (72.4 %). Among these forms, there were 34 cases of negative microscopy tuberculosis and 21 cases of positive microscopy tuberculosis. The extrapulmonary forms (21 cases) were dominated by tuberculosis in the lymph nodes (11 cases), the pleura (7), pericardium (2), and peritoneum (1). Anemia was found in 44 patients. Severe immunosuppression was noted in 90 %, with CD4+ cell counts <350/mm3. Lethality was 7.9 %. TB/HIV coinfection is a major public health problem in Africa. Better coordination of activities in support of programs for tuberculosis and HIV/AIDS are needed.
确定结核病的患病率，并描述其在艾滋病毒感染者中的流行病学、临床、辅助检查及治疗特征和转归。这项回顾性、描述性和分析性研究检查了我们门诊治疗中心艾滋病毒感染者的记录，并选取了2008年1月至2012年12月期间未接受过抗逆转录病毒治疗且患有结核病的患者。在总共757名艾滋病毒阳性患者中，76人患有结核病，患病率为10%。男女比例为1.23，男性居多。平均年龄为42.5岁（范围：25至69岁）。几乎所有这些患者（71例）感染的都是HIV-1。有39.5%的患者有结核病病史。17名患者营养不良。治疗措施包括对64名患者使用复方新诺明进行化学预防。以肺部结核为主（72.4%）。在这些类型中，有34例痰涂片阴性结核病和21例痰涂片阳性结核病。肺外结核（21例）以淋巴结结核（11例）、胸膜炎（7例）、心包炎（2例）和腹膜炎（1例）为主。44名患者存在贫血。90%的患者有严重免疫抑制，CD4 +细胞计数<350/mm³。死亡率为7.9%。结核/艾滋病毒合并感染是非洲的一个主要公共卫生问题。需要更好地协调支持结核病和艾滋病毒/艾滋病项目的活动。
