Rajaram Manju, Ravindra Adimulam Ganga, Dwivedi Dharm Prakash, Ramakrishnan Jayalakshmi, Chinnakali Palanivel, Mohapatra Madhusmita Mohanty
Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Adv Respir Med. 2018;86(5):211-214. doi: 10.5603/ARM.2018.0033.
In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group on TB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases.
Our study was a cross-sectional study, conducted between June 2015 and December 2016 in a tertiary care institute (JIPMER), in South India, to estimate the prevalence of HIV among presumptive TB cases.
Among the 964 presumptive TB cases who attended pulmonary medicine OPD, 189 patients were sputum acid-fast bacilli (AFB) positive. Among the 189 sputum positive cases, 9 were HIV positive. Of the 964 presumptive TB cases, 879 gave consent for HIV testing and 33 (3.7%) turned out to be HIV positive. If only sputum positive cases had been screened for HIV, we would have missed 24 new HIV positive cases. The number needed to screen was 27 among presumptive TB cases and 18 among TB patients.
The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptive TB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry. This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so that anti-retroviral therapy (ART) can be initiated early.
在印度,为了提高人类免疫缺陷病毒(HIV)病例的检出率,结核病/艾滋病国家技术工作组规定对疑似结核病(TB)病例进行HIV感染筛查为强制性要求。
我们的研究是一项横断面研究,于2015年6月至2016年12月在印度南部的一家三级医疗机构(JIPMER)进行,以评估疑似结核病病例中HIV的流行情况。
在964名到呼吸内科门诊就诊的疑似结核病病例中,189例患者痰涂片抗酸杆菌(AFB)阳性。在这189例痰涂片阳性病例中,9例HIV阳性。在964例疑似结核病病例中,879例同意进行HIV检测,其中33例(3.7%)HIV阳性。如果仅对痰涂片阳性病例进行HIV筛查,我们将遗漏24例新的HIV阳性病例。在疑似结核病病例中,每筛查27例可发现1例HIV阳性病例;在结核病患者中,每筛查18例可发现1例HIV阳性病例。
与本地治里修订后的国家结核病控制规划(RNTCP)机制相比,疑似结核病患者中HIV检测的接受率(91%)和HIV阳性病例3.7%的诊断率相当高。这进一步强调了对所有疑似病例进行HIV感染筛查的必要性,以提高HIV病例的检出率,从而能够尽早启动抗逆转录病毒治疗(ART)。