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探讨南非耐多药结核病治疗启动时的艾滋病相关指标。

Exploring HIV disease indicators at MDR-TB treatment initiation in South Africa.

机构信息

Johns Hopkins University School of Nursing, Baltimore, MD, USA.

Johns Hopkins Center for Infectious Disease and Nursing Innovation, Baltimore, MD, USA.

出版信息

Int J Tuberc Lung Dis. 2024 Jan 1;28(1):42-50. doi: 10.5588/ijtld.23.0242.

Abstract

Understanding relationships between HIV and multidrug-resistant TB (MDR-TB) is crucial for ensuring successful MDR-TB outcomes. We used a cross-sectional analysis to evaluate sociodemographic and clinical characteristics as correlates of antiretroviral therapy (ART) use, having an HIV viral load (VL) result, and HIV viral suppression in a cross-sectional sample of people with HIV (PWH) and MDR-TB enrolled in a cluster-randomized trial of nurse case management to improve MDR-TB outcomes. Among 1,479 PWH, the mean age was 37.1 years; 809 (54.7%) were male, and 881 (59.6%) were taking ART. Housing location, employment status, and CD4 count differed significantly between those taking vs. those not taking ART. Among the 881 taking ART, 681 (77.3%) had available HIV VL results. Housing location, CD4 count, and prior history of TB differed significantly between those with and without a VL result. Among the 681 with a VL result, 418 (61.4%) were virally suppressed. Age, education level, CD4 count, TB history, housing location, and ART type differed significantly between those with and without viral suppression. PWH presenting for MDR-TB treatment with a history of TB, taking a protease inhibitor, or living in a township may risk poor MDR-TB outcomes.

摘要

了解艾滋病毒与耐多药结核病(MDR-TB)之间的关系对于确保 MDR-TB 治疗成功至关重要。我们使用横断面分析来评估社会人口统计学和临床特征与抗逆转录病毒治疗(ART)的使用、艾滋病毒病毒载量(VL)结果以及 HIV 病毒抑制之间的相关性,这是在一项关于护士病例管理以改善 MDR-TB 结果的簇随机试验中纳入的 HIV 合并 MDR-TB 的患者的横断面样本。在 1479 名 HIV 患者中,平均年龄为 37.1 岁;809 名(54.7%)为男性,881 名(59.6%)正在接受 ART 治疗。接受与未接受 ART 治疗的患者在住房位置、就业状况和 CD4 计数方面存在显著差异。在接受 ART 治疗的 881 名患者中,681 名(77.3%)有可用的 HIV VL 结果。住房位置、CD4 计数和既往结核病史在有和无 VL 结果的患者之间存在显著差异。在有 VL 结果的 681 名患者中,418 名(61.4%)病毒得到抑制。年龄、教育程度、CD4 计数、结核病史、住房位置和 ART 类型在有和无病毒抑制的患者之间存在显著差异。因结核病、使用蛋白酶抑制剂或居住在乡镇而就诊接受 MDR-TB 治疗的 HIV 患者可能面临不良 MDR-TB 结局的风险。

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