KIT Royal Tropical Institute, Amsterdam, The Netherlands.
University of Economics and Innovation, Lublin, Poland.
Ann Agric Environ Med. 2020 Dec 22;27(4):695-701. doi: 10.26444/aaem/118611. Epub 2020 Mar 23.
According to data from the National Centre for Prevention and Control of AIDS, in the Republic of Kazakhstan, 45.8% of patients in the symptomatic stages of HIV infection are diagnosed with tuberculosis (TB) which is the cause of death in 36% of patients infected with HIV.
The aim of the study was to conduct a retrospective analysis of the effectiveness of tuberculosis (TB) chemoprophylaxis among people living with HIV in the Republic of Kazakhstan (RK) in Central Asia.
Materials and method. A retrospective analysis of patient health status was performed for each of the 648 patients (323 in the study group and 325 in the control group) during 2010-2015. Data from outpatient treatment charts were used concerning each patient infected with HIV observed at AIDS Treatment Centres. From among the 648 patients infected with HIV, 136 were receiving isoniazid in 2010, and 187 in 2011. The control group consisted of 325 people living with HIV (PLW HIV), who did not received isoniazid during observation.
Results. The incidence of TB in patients who underwent chemoprophylaxis did not exceed 0.555/ 100,000 population in the first year of observation. Within 5 years, the TB incidence dropped to 0. In the control group, the TB incidence rate during the first year of observation was 3.262/100,000, with a decrease to 0.364 observed in 2015. Cumulated incidence rate in 2011-2015 in the study group accounted for 1.276/100,000. In the control group, the cumulative incidence was 4.3 times higher and accounted for 5.527. A significant difference in the mortality rate due to TB in the study and control groups was observed, the share of deaths due to TB in study group was 21.6% - nearly 3 times lower than in the control group (57.0%).
Conclusions. The effectiveness of chemoprophylaxis for TB depends on biomedical, organizational and cultural factors. The presence of HIV co-infections is a special situation. Opposite to the majority of reports, in own study, no drug-resistant forms of tuberculosis were observed in relation with chemoprophylaxis with isoniazid. In the examined population, TB chemoprophylaxis reduced the incidence and cumulative incidence of TB among PLW HIV by 3.4-4.8 times. Isoniazid chemoprophylaxis decreased 4-fold the annual and cumulative mortality due to TB.
根据国家艾滋病预防和控制中心的数据，在哈萨克斯坦共和国，45.8%的艾滋病毒感染症状期患者被诊断患有结核病（TB），这是 36%艾滋病毒感染者的死亡原因。
本研究旨在对中亚哈萨克斯坦共和国（RK）艾滋病毒感染者进行结核（TB）化学预防的有效性进行回顾性分析。
对 2010-2015 年间 648 名患者（研究组 323 名，对照组 325 名）的健康状况进行回顾性分析。使用了每位在艾滋病治疗中心观察到的感染艾滋病毒的患者的门诊治疗图表中的数据。在 648 名感染艾滋病毒的患者中，2010 年有 136 名接受异烟肼治疗，2011 年有 187 名。对照组由 325 名未接受异烟肼治疗的艾滋病毒感染者（PLW HIV）组成。
结果。在观察的第一年，接受化学预防的患者中结核病的发病率不超过每 10 万人 0.555 人。在 5 年内，结核病的发病率下降到 0。在对照组中，观察第一年的结核病发病率为每 10 万人 3.262 人，2015 年下降到 0.364。2011-2015 年研究组累积发病率为每 10 万人 1.276 人。对照组累积发病率高 4 倍，为每 10 万人 5.527 人。研究组和对照组因结核病导致的死亡率差异显著，研究组因结核病死亡的比例为 21.6%，比对照组低近 3 倍（57.0%）。
结论。结核化学预防的效果取决于生物医学、组织和文化因素。存在艾滋病毒合并感染是一种特殊情况。与大多数报告相反，在本研究中，未观察到与异烟肼化学预防相关的耐多药结核病。在所检查的人群中，TB 化学预防使 PLW HIV 的 TB 发病率和累积发病率降低了 3.4-4.8 倍。异烟肼化学预防使每年和累积结核病死亡率降低了 4 倍。
