Nigussie Kedir, Gebeye Ejigu, Kifle Zemene Demelash, Tadesse Tesfaye Yimer, Birarra Mequanent Kassa
Department of Clinical Pharmacy School of Pharmacy College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics Institute of Public Health College of Medicine and Health Sciences University of Gondar, Gondar, Ethiopia.
Tuberc Res Treat. 2024 Aug 27;2024:9741157. doi: 10.1155/2024/9741157. eCollection 2024.
The World Health Organization (WHO) recommended isoniazid preventive therapy (IPT) to decrease the effects of tuberculosis (TB) on human immunodeficiency virus (HIV) patients. However, not enough research has been conducted to determine the impact of IPT on TB incidence and their predictors. Therefore, the goal of this study was to evaluate how IPT affects the incidence of TB and identify factors that are predictive of TB among HIV/AIDS patients. A total of 588 patients at Debre Tabor General Hospital (DTGH) who had taken IPT between December 2009 and January 2016 participated in the current study, which then followed them for 3 years and compared them to patients who did not receive IPT during the study period. The data were gathered from patient registries and charts. IPT users' and nonusers' TB-free survival curves were compared using log-rank testing. Predictors were identified using bivariate and multivariate Cox proportional hazards models. In this study, 1656 person-years (PYs) follow-ups on 588 patients found 82 additional TB cases, with an overall incidence rate (IR) of 4.95/100 PY. When compared to individuals who were not on IPT, the TB IR among patients living with human immunodeficiency virus (PLHIV) on IPT was significantly lower (1.94/100 PY vs. 8.32/100 PY). A baseline CD4 cell count < 200 cells/uL, history of TB, Hgb level < 10 g/dL, BMI < 18.5 kg/m, and not receiving IPT are independent predictors of TB among HIV/AIDS patients. The frequency of TB was high among PLHIV patients who did not receive IPT. It was discovered that a low CD4 cell count at baseline, a history of TB, IPT status, Hgb level, and BMI independently predicted the presence of TB. Therefore, addressing the independent predictors that are connected to a higher risk of TB in PLHIV as well as isoniazid (INH) prophylaxis has a significant impact on reducing the incidence of TB.
世界卫生组织(WHO)推荐使用异烟肼预防性治疗(IPT)来降低结核病(TB)对人类免疫缺陷病毒(HIV)患者的影响。然而,尚未进行足够的研究来确定IPT对结核病发病率及其预测因素的影响。因此,本研究的目的是评估IPT如何影响结核病发病率,并确定HIV/AIDS患者中结核病的预测因素。德布雷塔博尔综合医院(DTGH)共有588例在2009年12月至2016年1月期间接受IPT治疗的患者参与了本研究,随后对他们进行了3年的随访,并与研究期间未接受IPT治疗的患者进行比较。数据从患者登记册和病历中收集。使用对数秩检验比较IPT使用者和非使用者的无结核病生存曲线。使用二元和多元Cox比例风险模型确定预测因素。在本研究中,对588例患者进行了1656人年(PYs)的随访,发现了82例新增结核病病例,总发病率(IR)为4.95/100 PY。与未接受IPT治疗的个体相比,接受IPT治疗的人类免疫缺陷病毒(PLHIV)患者的结核病发病率显著更低(1.94/100 PY对8.32/100 PY)。基线CD4细胞计数<200个细胞/μL、结核病病史、血红蛋白水平<10 g/dL、体重指数<18.5 kg/m²以及未接受IPT治疗是HIV/AIDS患者中结核病的独立预测因素。未接受IPT治疗的PLHIV患者中结核病的发生率较高。研究发现,基线CD4细胞计数低、结核病病史、IPT治疗状态、血红蛋白水平和体重指数独立预测结核病的存在。因此,解决与PLHIV中较高结核病风险相关的独立预测因素以及异烟肼(INH)预防对降低结核病发病率具有重大影响。