Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
HIV Med. 2018 May;19(5):316-323. doi: 10.1111/hiv.12576. Epub 2018 Feb 21.
A high prevalence of tuberculosis (TB) among HIV-positive injecting drug users (IDUs) may fuel the TB epidemic in the general population of Romania. We determined the frequency and characteristics of TB in HIV-infected IDUs referred to a national centre.
Prospective observational cohort study of all newly-diagnosed HIV-positive IDUs admitted to Victor Babes Hospital, Bucharest, between January 2009 and December 2014. Socio-demographics, clinical characteristics and outcomes of HIV/TB co-infected IDUs were compared to HIV-positive IDUs without TB.
170/598 (28.5%) HIV-infected IDUs were diagnosed with TB. The prevalence increased from 12.5% in 2009 to 32.1% in 2014 (P < 0.001). HIV/TB co-infected individuals had lower median CD4 cell counts 75 (vs. 450/mm , P < 0.0001) and higher median HIV viral loads 5.6 log (vs. 4.9 log , P < 0.0001) when presenting to healthcare services. 103/170 (60.6%) HIV/TB co-infected IDUs were diagnosed with pulmonary TB. Resistant Mycobacterium tuberculosis strains were common, with 18/105 (17.1%) of patients having Multi-Drug Resistant (MDR) disease. Higher mortality rate was associated with TB co-infection (P < 0.0001), extra-pulmonary TB (P = 0.0026) and extensively drug resistant TB (P = 0.024).
Tuberculosis (TB) is an increasing problem in HIV-infected IDUs in Romania. Presentation is often with advanced HIV, significant TB drug resistance and consequent outcomes are poor.
罗马尼亚艾滋病毒阳性注射吸毒者（IDU）中结核病（TB）的高发率可能会助长该国普通人群中的 TB 流行。我们确定了转介至国家中心的 HIV 感染 IDU 中 TB 的频率和特征。
这是一项针对 2009 年 1 月至 2014 年 12 月期间在布加勒斯特 Victor Babes 医院新诊断出的所有 HIV 阳性 IDU 的前瞻性观察性队列研究。比较了 HIV/TB 合并感染 IDU 与未感染 TB 的 HIV 阳性 IDU 的社会人口统计学、临床特征和结局。
598 例 HIV 感染 IDU 中有 170 例（28.5%）诊断为 TB。2009 年至 2014 年，TB 合并感染的比例从 12.5%上升至 32.1%（P < 0.001）。就诊时，HIV/TB 合并感染个体的中位 CD4 细胞计数较低（75 个细胞/毫米 3，与 450 个细胞/毫米 3，P < 0.0001），中位 HIV 病毒载量较高（5.6 log ，与 4.9 log ，P < 0.0001）。170 例 HIV/TB 合并感染 IDU 中有 103 例（60.6%）诊断为肺结核。常见耐药结核分枝杆菌菌株，其中 18 例（17.1%）患者患有耐多药结核病（MDR）。TB 合并感染（P < 0.0001）、肺外结核（P = 0.0026）和广泛耐药结核病（P = 0.024）与更高的死亡率相关。
罗马尼亚 HIV 感染 IDU 中结核病（TB）是一个日益严重的问题。就诊时通常 HIV 状况较为晚期，TB 药物耐药情况显著，且预后不良。
