Sadirova Dilbar, Grigoryan Ruzanna, Parpieva Nargiza, Barotova Venera, Trubnikov Aleksandr, Kalandarova Lola, Gadoev Jamshid, Mukhtarov Davron, Buziashvili Mariana, Tukvadze Nestani, Hovhannesyan Arax, Dadu Andrei
Center of Phthisiology and Pulmonology of Tashkent City, Tashkent 100043, Uzbekistan.
TB Research and Prevention Center, Yerevan 0023, Armenia.
Int J Environ Res Public Health. 2021 May 27;18(11):5746. doi: 10.3390/ijerph18115746.
People living with the human immunodeficiency virus (PLHIV) have a higher risk of developing active tuberculosis (TB) disease, and TB remains a major cause of death in PLHIV. Uzbekistan is facing a substantial TB epidemic, which increases the risk of PLHIV developing active TB. Our retrospective cohort study aimed to evaluate the incidence rate and assess the risk factors for developing active TB among PLHIV. We collected secondary data extracted from medical charts of all patients, newly diagnosed at the AIDS Center in Tashkent, during the period of 2015-2017. The incidence rate of TB among PLHIV was 5.1 (95% CI: 4.5-6.0) per 1000 person/month. Adjusted regression analysis showed three major risk factors for TB, namely, being less than 15 years old (hazard ratio (HR) 5.83; 95% CI: 3.24-10.50, value = 0.001),low CD4 count (adjusted hazard ratio(aHR) 21.0; 95% CI: 9.25-47.7, value < 0.001), and antiretroviral therapy (ART) interruption/not receiving ART (aHR 5.57; 95% CI: 3.46-8.97 and aHR 6.2; 95% CI: 3.75-10.24, value < 0.001, respectively) were significantly associated with developing active TB among PLHIV. Our findings indicate that taking prescribed ART without interruptions and maintaining CD4cell counts higher than 320 cells/μL are essential to prevent the development of active TB among PLHIV.
感染人类免疫缺陷病毒（PLHIV）的人群患活动性结核病（TB）的风险更高，结核病仍然是PLHIV患者死亡的主要原因。乌兹别克斯坦正面临严重的结核病流行，这增加了PLHIV患者患活动性结核病的风险。我们的回顾性队列研究旨在评估PLHIV患者中活动性结核病的发病率，并评估其危险因素。我们收集了2015年至2017年期间在塔什干艾滋病中心新诊断的所有患者病历中的二手数据。PLHIV患者中结核病的发病率为每1000人/月5.1例（95%置信区间：4.5-6.0）。校正回归分析显示结核病的三个主要危险因素，即年龄小于15岁（风险比（HR）5.83；95%置信区间：3.24-10.50，P值=0.001）、CD4细胞计数低（校正风险比（aHR）21.0；95%置信区间：9.25-47.7，P值<0.001）以及抗逆转录病毒治疗（ART）中断/未接受ART（aHR 5.57；95%置信区间：3.46-8.97和aHR 6.2；95%置信区间：3.75-10.24，P值均<0.001）与PLHIV患者发生活动性结核病显著相关。我们的研究结果表明，不间断地服用规定的ART并将CD4细胞计数维持在高于320个细胞/μL对于预防PLHIV患者发生活动性结核病至关重要。
