沙特阿拉伯西南部吉赞地区艾滋病毒/艾滋病患者中的结核病。

Tuberculosis among people living with HIV/AIDS in Jazan Region, Southwestern Saudi Arabia.

机构信息

Department of Internal Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.

Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.

出版信息

J Infect Public Health. 2021 Nov;14(11):1571-1577. doi: 10.1016/j.jiph.2021.09.009. Epub 2021 Sep 30.

DOI:10.1016/j.jiph.2021.09.009

PMID:34656963

Abstract

BACKGROUND

Tuberculosis (TB) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) infections are leading causes of morbidity and mortality worldwide. People living with HIV/AIDS (PLWHA) are highly susceptible to TB infection and progression to active TB disease. This study aims to determine the proportion and risk factors of TB among PLWHA in Jazan Region, southwestern Saudi Arabia.

METHODS

A cross-sectional study was conducted among HIV-infected individuals attending the main referral hospital in Jazan Region during the period 2017-2019. The participants' TB status, CD4+ lymphocyte count, and viral load were assessed. In addition, their demographic and clinical information was collected using a structured questionnaire.

RESULTS

A total of 316 HIV-positive individuals aged between 13 and 81 years (75% male and 25% female) were enrolled in this study. Of them, 30 (9.5%; 95% confidence interval [CI]: 5.2, 10.6%) were diagnosed with TB: 46.7% (14/30) had pulmonary TB and 53.3% (16/30) had extrapulmonary TB. The highest proportion of TB-positive PLWHA was found among participants aged 18-30 years (11.6%) and among non-Saudis (14.0%) when compared to other age groups and Saudi participants (7.4%). Multivariate analysis showed that male gender (adjusted odds ratio [AOR] = 4.79; 95% CI = 1.22, 18.74), past medical history (PMH) of TB (AOR = 29.67; 95% CI = 5.31, 164.32), PMH of other RTIs (AOR = 5.86; 95 % CI = 2.14, 16.06), CD4+ lymphocyte count of <200 cells/mm³ (AOR = 4.33; 95% CI = 1.65, 11.36), and viral load of ≥1 × 10 copies/mL (AOR = 5.46; 95% CI = 2.02, 14.77) were the significant risk factors of TB among the studied PLWHA.

CONCLUSION

The prevalence of TB/HIV co-infection among the studied population was 9.5%. Therefore, all PLWHA should be screened for TB at every visit to a health facility. The findings highlight that integration of health services for both TB and HIV/AIDS in Saudi Arabia is recommended.

摘要

背景

结核病（TB）和人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）感染是全球发病率和死亡率的主要原因。艾滋病毒感染者/艾滋病患者（PLWHA）极易感染结核病并发展为活动性结核病。本研究旨在确定沙特阿拉伯西南部的吉赞地区 PLWHA 中结核病的比例和危险因素。

方法

2017 年至 2019 年期间，对在吉赞地区主要转诊医院就诊的 HIV 感染者进行了一项横断面研究。评估了参与者的结核病状态、CD4+淋巴细胞计数和病毒载量。此外，还使用结构化问卷收集了他们的人口统计学和临床信息。

结果

共纳入 316 名年龄在 13 至 81 岁之间（75%为男性，25%为女性）的 HIV 阳性个体。其中，30 人（9.5%；95%置信区间 [CI]：5.2，10.6%）被诊断患有结核病：46.7%（14/30）为肺结核，53.3%（16/30）为肺外结核病。在所有年龄组和沙特参与者（7.4%）中，18-30 岁的 PLWHA 中结核病阳性者比例最高（11.6%），而非沙特参与者比例最高（14.0%）。多变量分析显示，男性（调整后的优势比 [AOR] = 4.79；95%CI = 1.22, 18.74）、结核病既往史（AOR = 29.67；95%CI = 5.31, 164.32）、其他 RTIs 既往史（AOR = 5.86；95%CI = 2.14, 16.06）、CD4+淋巴细胞计数 <200 个细胞/mm³（AOR = 4.33；95%CI = 1.65, 11.36）和病毒载量≥1×10 拷贝/mL（AOR = 5.46；95%CI = 2.02, 14.77）是研究中 PLWHA 结核病的显著危险因素。