伊朗结核病/艾滋病病毒合并感染的患病率：系统评价与荟萃分析

Prevalence of TB/ HIV co-infection in Iran: a systematic review and meta-analysis.

作者信息

Pourakbari B, Mamishi S, Banar M, Keshtkar A A, Mahmoudi S

机构信息

Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran.

Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran - Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Ann Ig. 2019 Jul-Aug;31(4):333-348. doi: 10.7416/ai.2019.2295.

DOI:10.7416/ai.2019.2295

PMID:31268118

Abstract

INTRODUCTION

Co-infection of TB/ HIV is an emerging threat to a global public health. Although several studies have investigated the prevalence of TB/HIV co-infection in Iran, the results are inconsistent. The current systematic review and meta-analysis was planned to estimate the overall prevalence of TB/HIV co-infection in Iran.

METHODS

Electronic databases, including MEDLINE (via PubMed), SCOPUS, SID and Mag Iran (two Persian scientific search engines) were searched up to 27 Apr 2017. The random effect model was used for estimating the prevalence of TB/ HIV co-infection. Heterogeneity was assessed by subgroup analysis.

RESULTS

Forty-eight articles met our inclusion criteria, with a total of 21,388 individuals. The meta-analysis demonstrates that the prevalence of TB/ HIV co-infection in Iran was 14% [95% confidence interval CI:12-15%]. According to the meta-analysis of 5 subgroups, the prevalence of TB/ HIV co-infection in the subgroup with high intravenous drug users (IVDU) [27%, 95% CI: 20-35%], in border provinces of Iran [17%, 95% CI: 13-21%], in the subgroup with pulmonary tuberculosis (PTB) ≥ 20% [22%, 95% CI: 17-27%], in patients <40 years of age [25%, 95 CI: 19-31%] was significantly higher. There were no significant differences between the prevalence of co-infection among low and high-quality studies. Pulmonary TB was the predominant type of TB among co-infected patients [77%, 95% CI: 71 to 84%].

CONCLUSIONS

Our study demonstrates that the overall prevalence of TB/HIV co-infection in Iran was 14% [95% CI: 12-15%], which was a high rate. Some factors such as using intravenous drugs, living in border provinces of Iran, having PTB, and age <40 years had an impact on the prevalence of co-infection. Results revealed the need of HIV surveillance program among TB patients and screening of HIV-positive patients for diagnosis and treatment of TB. Further large-scale studies about the prevalence of this infection in all provinces of Iran are needed.

摘要

引言

结核病/艾滋病病毒合并感染对全球公共卫生构成了新的威胁。尽管已有多项研究调查了伊朗结核病/艾滋病病毒合并感染的患病率，但结果并不一致。本系统评价和荟萃分析旨在估计伊朗结核病/艾滋病病毒合并感染的总体患病率。

方法

检索了电子数据库，包括MEDLINE（通过PubMed）、SCOPUS、SID和Mag Iran（两个波斯语科学搜索引擎），检索截止至2017年4月27日。采用随机效应模型估计结核病/艾滋病病毒合并感染的患病率。通过亚组分析评估异质性。

结果

48篇文章符合纳入标准，共涉及21388名个体。荟萃分析表明，伊朗结核病/艾滋病病毒合并感染的患病率为14%[95%置信区间CI：12 - 15%]。根据对5个亚组的荟萃分析，静脉吸毒者比例高的亚组中结核病/艾滋病病毒合并感染的患病率[27%，95%CI：20 - 35%]、伊朗边境省份的患病率[17%，95%CI：13 - 21%]、肺结核（PTB）≥20%的亚组中的患病率[22%，95%CI：17 - 27%]、年龄<40岁患者中的患病率[25%，95%CI：19 - 31%]显著更高。低质量和高质量研究中合并感染的患病率之间无显著差异。肺结核是合并感染患者中结核病的主要类型[77%，95%CI：71至84%]。

结论

我们的研究表明，伊朗结核病/艾滋病病毒合并感染的总体患病率为14%[95%CI：12 - 15%]，这一患病率较高。使用静脉药物、居住在伊朗边境省份、患有肺结核以及年龄<40岁等因素对合并感染的患病率有影响。结果表明有必要在结核病患者中开展艾滋病病毒监测项目，并对艾滋病病毒阳性患者进行筛查以诊断和治疗结核病。还需要在伊朗所有省份开展关于这种感染患病率的进一步大规模研究。