Department of Medicine, Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand.
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
HIV Res Clin Pract. 2024 Dec;25(1):2348935. Epub 2024 May 3.
Tuberculosis (TB) poses a significant risk to people with HIV (PWH), with heightened incidence and prevalence rates, especially in countries with a high TB burden. This study assesses the prevalence and incidence rates of TB among PWH during the COVID-19 pandemic, and on treatment outcomes in TB-HIV co-infections.
A retrospective study was conducted at Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand, from January 2020 to September 2023, involving newly diagnosed adult PWH. Data were collected on TB prevalence and incidence rates, with TB cases categorized as definite or possible. The primary outcomes were TB prevalence and incidence rates per 100,000 person-years of follow-up.
Among 171 newly diagnosed PWH, the prevalence of TB was 5.85%, with an incidence rate of 4,568.71 per 100,000 person-years. All but one TB cases were diagnosed before antiretroviral therapy (ART) initiation. There was no incident TB during the follow-up period during ART. Nearly half of the TB cases required therapeutic trials without microbiological confirmation.
The study revealed a high prevalence and incidence rate of TB among PWH during the COVID-19 pandemic, comparable to pre-pandemic rates in Thailand. The findings highlight the necessity of comprehensive TB screening prior to ART initiation and the cautious implementation of universal TB preventive therapy. The use of molecular diagnostics, in addition to symptom screening, can enhance TB diagnosis among PWH, though accessibility remains an issue in many regions.
结核病（TB）对艾滋病毒感染者（PWH）构成重大威胁，发病率和患病率较高，尤其是在结核病负担高的国家。本研究评估了 COVID-19 大流行期间 PWH 中的结核病患病率和发病率，以及结核病-艾滋病毒合并感染的治疗结局。
这是一项在泰国玛哈沙拉堪大学苏达威医院进行的回顾性研究，时间为 2020 年 1 月至 2023 年 9 月，涉及新诊断的成年 PWH。收集了结核病的患病率和发病率数据，将结核病病例分为明确或可能。主要结局是每 100,000 人年随访的结核病患病率和发病率。
在 171 例新诊断的 PWH 中，结核病的患病率为 5.85%，发病率为每 100,000 人年 4,568.71 例。除了一例外，所有结核病病例均在开始抗逆转录病毒治疗（ART）之前诊断。在 ART 随访期间没有发生新的结核病。近一半的结核病病例需要未经微生物学确认的治疗试验。
该研究显示，COVID-19 大流行期间 PWH 的结核病患病率和发病率很高，与泰国大流行前的比率相当。研究结果强调了在开始 ART 之前进行全面的结核病筛查以及谨慎实施普遍的结核病预防性治疗的必要性。除了症状筛查外，使用分子诊断可以提高 PWH 的结核病诊断能力，但在许多地区，这仍然存在可及性问题。
