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一项基于医院的HIV-TB合并感染观察性研究。

A hospital-based observational study on HIV-TB co-infection.

作者信息

Soni Akansha, Venkatesh Vimala, Jain Parul, Jain Amita, Himanshu Reddy D, Gupta Neetu, Tandon Ritu

机构信息

Department of Microbiology, King George's Medical University, Lucknow, India.

Department of Medicine, King George's Medical University, Lucknow, India.

出版信息

Access Microbiol. 2025 Aug 6;7(8). doi: 10.1099/acmi.0.000787.v4. eCollection 2025.

Abstract

Human immunodeficiency virus (HIV) is the major cause of failure to reach targets of tuberculosis (TB) control in settings with high HIV loads. TB, on the other hand, enhances the progression of HIV infection to AIDS. This study was done to understand the epidemiological and clinical profile of HIV-TB co-infected patients and to study the impact of TB on the recovery of CD4 counts. An observational study was conducted in which of the 573 patients newly diagnosed with HIV infection and enrolled at the antiretroviral therapy (ART) centre, King George's Medical University, Lucknow, between May 2021 and June 2022, 80 patients who also had newly diagnosed TB were included. These HIV-TB co-infected patients were analysed for demographic factors. Also, clusters of differentiation 4 (CD4) counts were done at the time of enrolment on ART and then later, ~6 to 8 months of recieving ART and anti-tubercular treatment (ATT) initiation. For comparison, of the 493 HIV-only patients, 50 age- and gender-matched consecutive patients for whom baseline and follow-up CD4 counts were available were enrolled as controls. The change from baseline CD4 count was calculated using a paired t-test and Wilcoxon signed rank test. In the present study, among HIV-TB co-infected patients, baseline CD4 levels were 194.52±162.27, and follow-up CD4 levels were 285.09±170.33. A statistically significant increment of 90.57±165.60 in mean CD4 levels was observed (=4.019; <0.001). Likewise, in only HIV-positive patients, a statistically significant increment of 125.26±191.48 (35.75%) cells in mean CD4 levels was observed (=4.626; <0.001). The increase in CD4 counts in HIV only population was significantly higher than that observed in HIV-TB co0infected patients. Though significant rise in CD4 counts was observed in both HIV-TB co-infected patients and HIV-only patients after 6 to 8 months of appropriate therapy, the rise was significantly higher among the HIV-only group as compared to the HIV-TB co-infected group.

摘要

人类免疫缺陷病毒(HIV)是在HIV感染率高的地区无法实现结核病(TB)控制目标的主要原因。另一方面,结核病会加速HIV感染向获得性免疫综合征(AIDS)的发展。本研究旨在了解HIV-TB合并感染患者的流行病学和临床特征,并研究结核病对CD4细胞计数恢复的影响。开展了一项观察性研究,在2021年5月至2022年6月期间于勒克瑙的乔治国王医科大学抗逆转录病毒治疗(ART)中心新诊断出HIV感染并登记入组的573例患者中,纳入了80例同时新诊断出结核病的患者。对这些HIV-TB合并感染患者的人口统计学因素进行了分析。此外,在ART入组时以及之后,即接受ART和抗结核治疗(ATT)开始约6至8个月时,进行了分化簇4(CD4)细胞计数。为作比较,在493例仅感染HIV的患者中,纳入了50例年龄和性别匹配且有基线和随访CD4细胞计数数据的连续患者作为对照。使用配对t检验和Wilcoxon符号秩检验计算基线CD4细胞计数的变化。在本研究中,HIV-TB合并感染患者的基线CD4水平为194.52±162.27,随访CD4水平为285.09±170.33。观察到平均CD4水平有统计学显著升高,为90.57±165.60(t = 4.019;P<0.001)。同样,仅HIV阳性患者的平均CD4水平有统计学显著升高,为125.26±191.48(35.75%)个细胞(t = 4.626;P<0.001)。仅感染HIV人群中CD4细胞计数的增加显著高于HIV-TB合并感染患者。虽然在适当治疗6至8个月后,HIV-TB合并感染患者和仅感染HIV患者的CD4细胞计数均有显著升高,但与HIV-TB合并感染组相比,仅感染HIV组的升高更为显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a104/12328067/796b03cd261d/acmi-7-00787-g001.jpg

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