Gümüşer Fatma, Altınkaynak Merve, Yıldız Sevgi Dilek, Altuntaş Aydın Özlem, Mete Bilgül, Gündüz Alper, Kumbasar Karaosmanoğlu Hayat, Bolukçu Sibel, Tabak Ömer Fehmi, Vahaboğlu Mustafa Haluk
Turk J Med Sci. 2018 Jun 14;48(3):503-508. doi: 10.3906/sag-1706-76.
Background/aim: This study was undertaken to identify subjects with human immunodeficiency virus and tuberculosis (HIV/TB) coinfection in a group of HIV-positive patients followed at five different healthcare centers, and to determine the demographic and clinical characteristics of these subjects as well as the predictors of mortality. Materials and methods: A database search for subjects with TB coinfection was performed among 1475 HIV-positive adult patients and a total of 66 individuals were identified with HIV/TB coinfection. Results: There were 66 patients (4.5%) with TB coinfection. Twenty-one percent (n = 14) of the patients with TB coinfection died during the study period and these patients had significantly lower baseline CD4 counts at the time of TB diagnosis (P = 0.005). None of the patients with CD4 count of ≥200 cells/mm3 died during follow-up and a low CD4 count at the time of TB diagnosis (<200 cells/ mm3) was associated with poor survival (P = 0.012). However, none of the parameters emerged as significant independent predictors of survival in multivariate analysis. Conclusion: Coexistence of TB and HIV infection is associated with many clinical challenges and a better understanding of patient characteristics as well as the parameters impacting the outcome will improve the quality of care provided for this group of patients.
背景/目的：本研究旨在确定在五个不同医疗中心接受随访的一组HIV阳性患者中合并感染人类免疫缺陷病毒和结核病（HIV/TB）的患者，并确定这些患者的人口统计学和临床特征以及死亡率的预测因素。材料与方法：在1475例HIV阳性成年患者中进行数据库搜索，以查找合并感染结核病的患者，共确定66例HIV/TB合并感染患者。结果：有66例（4.5%）患者合并感染结核病。在研究期间，21%（n = 14）的合并感染结核病患者死亡，这些患者在结核病诊断时的基线CD4细胞计数显著较低（P = 0.005）。CD4细胞计数≥200个/立方毫米的患者在随访期间均未死亡，结核病诊断时CD4细胞计数低（<200个/立方毫米）与生存率低相关（P = 0.012）。然而，在多变量分析中，没有任何参数成为生存的显著独立预测因素。结论：结核病和HIV感染并存带来许多临床挑战，更好地了解患者特征以及影响结局的参数将提高为这组患者提供的护理质量。
