Chaisson Lelia H, Durovni Betina, Umar Nasir, Cohn Silvia, Moulton Lawrence H, Scully Eileen, Cavalcante Solange, Golub Jonathan E, Chaisson Richard E, Saraceni Valeria
UCSF Center for Tuberculosis.
UCSF Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
AIDS. 2025 Feb 1;39(2):184-192. doi: 10.1097/QAD.0000000000004045. Epub 2024 Oct 24.
Worldwide, adult men experience an excess burden of tuberculosis (TB) disease compared with women, but few studies have examined sex differences in TB among people with HIV. In this study, we aimed to investigate sex differences in TB infection and disease among people with HIV in Rio de Janeiro, Brazil.
Analysis of data from a randomized controlled trial and retrospective cohort study.
We analyzed data from two studies conducted between 2005 and 2017. The THRio Study (2005-2012) evaluated increasing tuberculin skin testing (TST) and TB preventive therapy (TPT), and Universal ART in Rio study (UnivART; 2010-2017) was a virtual cohort study of people with HIV and TB with data from four national electronic registries.
Among 4606 people with HIV in THRio, 2992 (65.0%) had a TST placed and read, of whom 312 of 1865 (17%) males and 203 of 1127 (18%) females ( P = 0.37) had prevalent TB infection. TB disease incidence was higher among males compared with females overall [IRR 1.33, 95% confidence interval (95% CI) 1.04-1.69], among males compared with females who did not receive TPT [incidence rate ratios (IRR) 1.30, 95% CI 1.01-1.67], and among males compared with females on ART (IRR 1.64, 95% CI 1.17-2.29). Among 54 957 people with HIV in UnivART, TB disease incidence rates were higher among males than females overall (IRR 1.28, 95% CI 1.18-1.39), among males compared with females on ART (IRR 1.58, 95% CI 1.40-1.77), and among males compared with females not on ART (IRR 1.11, 95% CI 0.99-1.25).
In this medium TB and HIV burden setting, TB disease incidence was higher among males than females with HIV, despite similar prevalence of TB infection.
在全球范围内，成年男性患结核病的负担高于女性，但很少有研究调查艾滋病毒感染者中结核病的性别差异。在本研究中，我们旨在调查巴西里约热内卢艾滋病毒感染者中结核病感染和疾病的性别差异。
对一项随机对照试验和回顾性队列研究的数据进行分析。
我们分析了2005年至2017年期间进行的两项研究的数据。THRio研究（2005 - 2012年）评估了增加结核菌素皮肤试验（TST）和结核病预防性治疗（TPT），以及里约热内卢通用抗逆转录病毒治疗研究（UnivART；2010 - 2017年）是一项对艾滋病毒和结核病患者的虚拟队列研究，数据来自四个国家电子登记处。
在THRio研究的4606名艾滋病毒感染者中，2992人（65.0%）进行了TST检测并获得结果，其中1865名男性中有312人（17%）、1127名女性中有203人（18%）患有现患结核病感染（P = 0.37）。总体而言，男性的结核病发病率高于女性[发病率比（IRR）1.33，95%置信区间（95%CI）1.04 - 1.69]，未接受TPT的男性与女性相比[发病率比（IRR）1.30，95%CI 1.01 - 1.67]，接受抗逆转录病毒治疗的男性与女性相比（IRR 1.64，95%CI 1.17 - 2.29）。在UnivART研究的54957名艾滋病毒感染者中，总体上男性的结核病发病率高于女性（IRR 1.28，95%CI 1.18 - 1.39），接受抗逆转录病毒治疗的男性与女性相比（IRR 1.58，95%CI 1.40 - 1.77），未接受抗逆转录病毒治疗的男性与女性相比（IRR 1.11，95%CI 0.99 - 1.25）。
在这种结核病和艾滋病毒负担中等的环境中，尽管结核病感染率相似，但艾滋病毒感染者中男性的结核病发病率高于女性。
