Talebi-Taher Mahshid, Abbasian Ladan, Alavi-Niakou Seiedeh Nina, Javad-Moosavi Seied Ali, Pahlavani Seyedmahdi
Antimicrobial Resistance Research Centre, Infectious Diseases Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Iranian Research Centre of HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Tanaffos. 2017;16(3):201-206.
The risk of tuberculosis (TB) is greater for individuals with human immunodeficiency virus (HIV) who are on combined antiretroviral therapy (c-ART) than for the normal population. Therefore, the detection and treatment of latent tuberculosis infections is recommended for all HIV-positive persons with positive tuberculin skin tests (TSTs).
This retrospective cohort study included all HIV-positive individuals with CD4 lymphocyte counts greater than 200 cells/μL and negative TST results, who were taking antiretroviral drugs and had been referred to Imam Khomeini Teaching Hospital Consultation Centre for Clients with Risky Behaviors in Tehran, Iran, from 2008 to 2013. TST conversion to positivity is defined as an induration increase of at least 5 mm compared with a previously negative TST result within a 1-year period. Conversion rates are expressed in person-years of observation.
A total of 113 patients were included in our study. At 1 year, 9 of the 113 TST-negative patients taking c-ART became TST-positive (8%; 8 males and 1 female). The TST conversion incidence rate was 10.09/100 person-years. TST conversion was only found to be associated with sex (odds ratio: 8.64; 95% confidence interval: 1.04-7.56, p = 0.032).
Our results suggest that TSTs should be administered to all HIV-positive patients before beginning isoniazid preventive therapy in Iran.
接受联合抗逆转录病毒疗法（c-ART）的人类免疫缺陷病毒（HIV）感染者患结核病（TB）的风险高于正常人群。因此，建议对所有结核菌素皮肤试验（TST）呈阳性的HIV阳性者进行潜伏性结核感染的检测和治疗。
这项回顾性队列研究纳入了2008年至2013年期间所有CD4淋巴细胞计数大于200个细胞/μL且TST结果为阴性、正在服用抗逆转录病毒药物并被转诊至伊朗德黑兰伊玛目霍梅尼教学医院危险行为患者咨询中心的HIV阳性个体。TST转为阳性定义为在1年内与先前阴性的TST结果相比硬结增加至少5mm。转化率以观察人年表示。
我们的研究共纳入113例患者。1年后，113例接受c-ART治疗的TST阴性患者中有9例转为TST阳性（8%；8例男性和1例女性）。TST转化率为10.09/100人年。仅发现TST转换与性别有关（比值比：8.64；95%置信区间：1.04-7.56，p = 0.032）。
我们的结果表明，在伊朗，对所有HIV阳性患者在开始异烟肼预防性治疗前应进行TST检测。
