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印度比哈尔邦 HIV 合并结核病患者的流行病学决定因素和生活质量。

Epidemiological determinants and quality of life in PLHIV patients with tuberculosis in Bihar State, India.

机构信息

Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur, Bihar, India.

Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India.

出版信息

Indian J Tuberc. 2024;71 Suppl 2:S258-S263. doi: 10.1016/j.ijtb.2024.08.018. Epub 2024 Aug 30.

Abstract

BACKGROUND

This study aimed to determine the prevalence of TB among patients living with HIV in Patna district, India. It also assessed the factors contributing to co-infection and evaluated patients' quality of life.

METHODS

This cross-sectional study was conducted at the Antiretroviral Therapy (ART) Centre in Patna, India, for a period of eight months. The socio-demographic information was collected through a pre-defined semi-structured questionnaire administered by the interviewer during face-to-face interviews at the time of enrolment. Clinical details were obtained from the hospital records. The statistical analysis was performed using SPSS software.

RESULTS

The study showed that out of 289 people living with HIV, 31% had TB as a co-infection. Male patients had a higher probability of contracting HIV-TB co-infection compared to female patients. The study indicated that advanced WHO staging, male gender, past history of TB, and opportunistic infections were strong predictors. Conversely, the odds of HIV-TB co-infection reduced with a CD4 count of over 300 cells/mm3. However, an increase in age, lower socio-economic status, BMI below the normal range, and presence of comorbidities might increase the odds of HIV-TB co-infection but were not statistically significant. The QoL of HIV-TB patients was significantly lower than that of HIV-only patients.

CONCLUSIONS

People with low CD4 T cell count are at a higher risk of developing TB due to HIV/TB co-infection. The baseline clinical staging of HIV is significantly correlated with TB co-infection. Those in WHO Clinical Stage III and IV have a four times higher risk of developing TB.

摘要

背景

本研究旨在确定印度巴特那地区艾滋病毒感染者中结核病的流行情况。它还评估了导致合并感染的因素,并评估了患者的生活质量。

方法

这项横断面研究在印度巴特那的抗逆转录病毒治疗(ART)中心进行,为期八个月。社会人口统计学信息通过访谈员在登记时进行面对面访谈时使用预先确定的半结构式问卷收集。临床详细信息从医院记录中获得。统计分析使用 SPSS 软件进行。

结果

研究表明,在 289 名艾滋病毒感染者中,有 31%合并感染了结核病。与女性患者相比,男性患者感染艾滋病毒-结核病合并感染的可能性更高。研究表明,晚期世界卫生组织(WHO)分期、男性、既往结核病史和机会性感染是强有力的预测因素。相反,CD4 计数超过 300 个细胞/mm3 时,艾滋病毒-结核病合并感染的几率降低。然而,年龄增加、社会经济地位较低、BMI 低于正常范围以及存在合并症可能会增加艾滋病毒-结核病合并感染的几率,但无统计学意义。艾滋病毒-结核病患者的生活质量明显低于仅艾滋病毒患者。

结论

由于 HIV/TB 合并感染,CD4 T 细胞计数较低的人患结核病的风险更高。HIV 的基线临床分期与结核病合并感染显著相关。处于世界卫生组织临床分期 III 和 IV 期的患者患结核病的风险增加了四倍。

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