Division of Tuberculosis Control and Prevention, Fujian CDC, Fuzhou, 350000, China.
National Center for Tuberculosis Control and Prevention, China CDC, Beijing, 100000, China.
BMC Infect Dis. 2023 Aug 10;23(1):528. doi: 10.1186/s12879-023-08501-8.
Tuberculosis (TB) is a chronic respiratory infection. Co-infection with human immunodeficiency virus (HIV) has been a significant obstacle to TB control. Insufficient attention has been given to TB/HIV, and more information is needed to address this issue. We conducted an observational study to investigate the epidemiological characteristics, treatment outcomes and its associated factors of HIV-positive TB patients in Southeast China.
An observational study was conducted based on data collected directly from China National TB Surveillance System during 2012-2021. Epidemiological characteristics, drug resistance and outcomes were described as frequency (n) and percentage (%). Risk factors for unsuccessful outcomes were determined using univariate (chi-squared) and multivariate logistic regression analysis.
A total of 347 TB/HIV cases were included, and the proportion of HIV-positive cases among all TB cases increased significantly from 0.06% to 2012 to 0.40% in 2021. The majority of cases were males (86.5%), non-local household registers (139, 40.1%), farmers or workers (179, 51.6%), and aged 40-59 (142, 40.9%). Of 347 cases, 290 (83.6%) had pulmonary TB (PTB), 10 (2.9%) had extra pulmonary TB (EPTB) and 47(13.5%) had both PTB and EPTB. A total A total of 258 (74.4%) were HIV positive prior to TB diagnosis. 8.0% (4/50) of cases were resistant to rifampicin (RIF) and 274 patients (83.8%) had successful outcomes. Being non-local (AOR = 2.193, 95% CI = 1.196-4.022, P = 0.011) and diagnosed HIV infection after TB (AOR = 2.365, 95% CI = 1.263-4.430, P = 0.007) were independent risk factors for unsuccessful outcomes of anti-TB treatment.
During 2012-2021, the proportion of HIV-positive cases among all TB cases increased significantly in Southeast China. HIV-positive TB patients were significantly more likely to develop resistance to RIF and INH and unsuccessful anti-TB treatment. Non-local registration and becoming HIV positive after TB diagnosis were independent risk factors associated with unsuccessful outcomes.
结核病（TB）是一种慢性呼吸道感染。人类免疫缺陷病毒（HIV）合并感染一直是结核病控制的重大障碍。对结核病/艾滋病重视不够，需要更多信息来解决这一问题。我们进行了一项观察性研究，以调查中国东南部 HIV 阳性结核病患者的流行病学特征、治疗结果及其相关因素。
本研究基于 2012-2021 年期间直接从中国国家结核病监测系统收集的数据进行了一项观察性研究。描述了流行病学特征、耐药性和结果，频率（n）和百分比（%）。使用单变量（卡方）和多变量逻辑回归分析确定治疗结果不佳的危险因素。
共纳入 347 例结核病/艾滋病病例，HIV 阳性病例在所有结核病病例中的比例从 2012 年的 0.06%显著上升至 2021 年的 0.40%。大多数病例为男性（86.5%）、非本地户籍（139 例，40.1%）、农民或工人（179 例，51.6%）和 40-59 岁（142 例，40.9%）。347 例患者中，290 例（83.6%）为肺结核（PTB），10 例（2.9%）为肺外结核（EPTB），47 例（13.5%）同时患有 PTB 和 EPTB。258 例（74.4%）患者在诊断结核病之前已被诊断为 HIV 阳性。4 例（8.0%）对利福平（RIF）耐药，274 例（83.8%）患者治疗结果成功。非本地户籍（比值比 [OR] = 2.193，95%置信区间 [CI] = 1.196-4.022，P = 0.011）和结核病后诊断 HIV 感染（OR = 2.365，95%CI = 1.263-4.430，P = 0.007）是抗结核治疗结果不佳的独立危险因素。
2012-2021 年期间，中国东南部 HIV 阳性结核病病例在所有结核病病例中的比例显著上升。HIV 阳性结核病患者发生 RIF 和 INH 耐药及抗结核治疗失败的风险显著增加。非本地户籍和结核病后诊断 HIV 感染是与治疗结果不佳相关的独立危险因素。
