Barnes P F, Silva C, Otaya M
Department of Medicine, University of Southern California School of Medicine, Los Angeles, USA.
Am J Respir Crit Care Med. 1996 Apr;153(4 Pt 1):1448-50. doi: 10.1164/ajrccm.153.4.8616580.
To investigate the utility of testing all tuberculosis patients for HIV infection in Los Angeles, we prospectively evaluated 183 hospitalized patients with acid-fast smear-positive tuberculosis who gave no history of HIV infection. HIV serologic testing was performed, and the presence of risk factors for HIV infection was assessed by interview and review of the medical record. Thirty-three patients (18%) were infected with HIV. Based on data obtained by interview, 124 (68%) of 183 patients had at least one risk factor for HIV infection. The most common risk factors were related to heterosexual transmission of HIV (prostitute contact, multiple sex partners, and a history of sexually transmitted disease). These risk factors were frequently not documented in the medical record. Among the 33 patients who were infected with HIV, 30 were identified by interviewing as having significant risk factors. We concluded that most tuberculosis patients in Los Angeles have risk factors for HIV infection and that systematic questioning does not identify risk factors in all HIV-infected tuberculosis patients. These data support current recommendations to screen all tuberculosis patients for HIV infection.
为了调查在洛杉矶对所有结核病患者进行HIV感染检测的效用，我们前瞻性地评估了183例住院的抗酸涂片阳性结核病患者，这些患者均无HIV感染史。进行了HIV血清学检测，并通过访谈和查阅病历评估了HIV感染的危险因素。33例患者（18%）感染了HIV。根据访谈获得的数据，183例患者中有124例（68%）至少有一项HIV感染危险因素。最常见的危险因素与HIV的异性传播有关（与妓女接触、多个性伴侣以及性传播疾病史）。这些危险因素在病历中常常未被记录。在33例感染HIV的患者中，通过访谈确定有30例具有显著危险因素。我们得出结论，洛杉矶的大多数结核病患者有HIV感染危险因素，而系统询问并不能识别所有HIV感染的结核病患者的危险因素。这些数据支持目前对所有结核病患者进行HIV感染筛查的建议。
