Moreno Ralfh, Ravasi Giovanni, Avedillo Pedro, Lopez Rafael
Pan American Health Organization Pan American Health Organization Washington DC United States of America Pan American Health Organization, Washington DC, United States of America.
Rev Panam Salud Publica. 2020 May 22;44:e43. doi: 10.26633/RPSP.2020.43. eCollection 2020.
To inform about the most recent epidemiological trends and integrated programmatic response to tuberculosis (TB) and HIV coinfection in Latin America and the Caribbean (LAC).
A descriptive review analyzed the most relevant indicators on TB/HIV coinfection in 33 countries in LAC with a cross-sectional and time-trend approach. Data were obtained from publicly available databases and analyzed through simple proportions, weighted means, and risk ratios.
In LAC, during 2017, 80.8% of TB patients were actively screened for HIV, with a 25.6% increase between 2011 and 2017. In the same year, the proportion of TB patients with HIV-positive status was 11.2%, with a small but progressive reduction of 5% since 2011. The provision of antiretroviral therapy and anti-TB medication among TB/HIV coinfected patients for 2017 was at 60%. Only one-third of people living with HIV had access to isoniazid preventive therapy. Overall, the mortality in the TB/HIV cohort has not changed since 2012, hovering at around 20%.
TB/HIV collaborative activities, as the backbone to address TB/HIV coinfection, are being scaled up in LAC and some indicators show a tendency toward improvement; nevertheless, our review shed light on the need to keep strengthening integration of service delivery, joint monitoring and evaluation, and data quality.
介绍拉丁美洲和加勒比地区（LAC）结核病（TB）与艾滋病毒合并感染的最新流行病学趋势及综合规划应对措施。
采用描述性综述，通过横断面和时间趋势方法分析了LAC地区33个国家与TB/艾滋病毒合并感染相关的最关键指标。数据取自公开可用数据库，并通过简单比例、加权均值和风险比进行分析。
在LAC地区，2017年80.8%的结核病患者接受了艾滋病毒主动筛查，2011年至2017年期间增长了25.6%。同年，艾滋病毒检测呈阳性的结核病患者比例为11.2%，自2011年以来虽有小幅但持续的5%的下降。2017年，TB/艾滋病毒合并感染患者中接受抗逆转录病毒治疗和抗结核药物治疗的比例为60%。只有三分之一的艾滋病毒感染者能够获得异烟肼预防性治疗。总体而言，自2012年以来，TB/艾滋病毒队列的死亡率没有变化，徘徊在20%左右。
作为应对TB/艾滋病毒合并感染核心的TB/艾滋病毒合作活动正在LAC地区扩大规模，一些指标显示出改善趋势；然而，我们的综述表明仍需持续加强服务提供的整合、联合监测与评估以及数据质量。
