International Union Against Tuberculosis and Lung Disease (The Union), Myanmar Office, Mandalay, Myanmar, Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA.
The Union, Paris, France.
Int J Tuberc Lung Dis. 2019 Mar 1;23(3):322-330. doi: 10.5588/ijtld.18.0448.
Myanmar, a country with a high human immunodeficiency virus-tuberculosis (HIV-TB) burden, where the tuberculin skin test or interferon-gamma release assays are not routinely available for the diagnosis of latent tuberculous infection.
To assess the effect of isoniazid (INH) preventive therapy (IPT) on the risk of TB disease and mortality among people living with HIV (PLHIV).
A retrospective cohort study of routinely collected data on PLHIV enrolled into care between 2009 and 2014.
Of 7177 patients (median age 36 years, interquartile range 31-42; 53% male) included in the study, 1278 (18%) patients received IPT. Among patients receiving IPT, 855 (67%) completed 6 or 9 months of INH. Patients who completed IPT had a significantly lower risk of incident TB than those who never received IPT (adjusted hazard ratio [aHR] 0.21, 95%CI 0.12-0.34) after controlling for potential confounders. PLHIV who received IPT had a significantly lower risk of death than those who never received IPT (PLHIV who completed IPT, aHR 0.25, 95%CI 0.16-0.37; those who received but did not complete IPT, aHR 0.55, 95%CI 0.37-0.82).
Among PLHIV in Myanmar, completing a course of IPT significantly reduced the risk of TB disease, and receiving IPT significantly reduced the risk of death.
缅甸是一个艾滋病毒-结核（HIV-TB）负担沉重的国家，该国常规不提供结核菌素皮肤试验或干扰素-γ释放试验来诊断潜伏性结核感染。
评估异烟肼（INH）预防治疗（IPT）对 HIV 感染者（PLHIV）发生结核病和死亡风险的影响。
这是一项回顾性队列研究，对 2009 年至 2014 年间常规入组的 PLHIV 数据进行了分析。
本研究共纳入了 7177 例患者（中位年龄 36 岁，四分位间距 31-42；53%为男性），其中 1278 例（18%）患者接受了 IPT。在接受 IPT 的患者中，855 例（67%）完成了 6 或 9 个月的 INH 治疗。在控制了潜在混杂因素后，与从未接受 IPT 的患者相比，接受 IPT 的患者发生结核病的风险显著降低（校正后的危险比 [aHR] 0.21，95%CI 0.12-0.34）。与从未接受 IPT 的患者相比，接受 IPT 的 PLHIV 死亡风险显著降低（完成 IPT 的 PLHIV，aHR 0.25，95%CI 0.16-0.37；接受但未完成 IPT 的 PLHIV，aHR 0.55，95%CI 0.37-0.82）。
在缅甸的 PLHIV 中，完成 IPT 疗程可显著降低结核病发病风险，而接受 IPT 可显著降低死亡风险。
