López J, Welvaart H, Ford W, Kerndt P
HIV Epidemiology Program, Los Angeles County Department of Health Services, CA 90005, USA.
Ann Epidemiol. 1998 Apr;8(3):168-74. doi: 10.1016/s1047-2797(97)00192-0.
This study aimed to describe prevalence of and risk factors for HIV among persons with newly diagnosed class III (confirmed) and class V (suspected) cases of tuberculosis (TB) patients in Los Angeles County.
HIV testing was performed on 1307 blood specimens after routine tests were completed at six TB clinics in Los Angeles County. HIV test results were matched to demographic and risk behavior information by use of an unlinked study methodology.
The overall HIV prevalence rate was 10.8%. By demographic characteristics, the highest prevalence rates were observed among persons born in the United States (15.7%), males (14.1%), blacks (14.3%), and those aged 30-44 years (14.4%). Confirmed TB cases (14%) were more likely to be HIV-infected than were suspect cases (9.6%). Risk behaviors associated with positive HIV serostatus included the injection of nonprescription drugs, having sex with an injection drug user, and use of noninjection forms of heroin, cocaine, and tranquilizers. Men who have sex with men were more likely to be HIV-infected than were heterosexual males.
HIV testing and counseling should be a standard of care in TB clinics. The observed high HIV prevalence rate reinforces the importance of designing prevention strategies that specifically target patients with TB.
本研究旨在描述洛杉矶县新诊断的III类（确诊）和V类（疑似）肺结核（TB）患者中HIV的流行情况及危险因素。
在洛杉矶县的六家结核病诊所完成常规检测后，对1307份血液标本进行了HIV检测。通过使用非关联研究方法，将HIV检测结果与人口统计学和风险行为信息进行匹配。
总体HIV流行率为10.8%。按人口统计学特征来看，在美国出生的人（15.7%）、男性（14.1%）、黑人（14.3%）以及30 - 44岁的人（14.4%）中观察到的流行率最高。确诊的TB病例（14%）比疑似病例（9.6%）更有可能感染HIV。与HIV血清阳性相关的风险行为包括注射非处方药、与注射吸毒者发生性行为以及使用非注射形式的海洛因、可卡因和镇静剂。男男性行为者比异性恋男性更有可能感染HIV。
HIV检测和咨询应成为结核病诊所的标准医疗服务。观察到的高HIV流行率强化了制定专门针对TB患者的预防策略的重要性。
