结核病人中HIV感染现状调查结果分析  

ANALYSIS OF HIV PREVALENCE AMONG TB PATIENTS IN HENAN PROVINCE

作　　者：甄新安[1] 马士文[1] 雷朝宽 王国杰[1] 

机构地区：[1]河南省疾病预防控制中心,郑州450016 [2]河南省卫生厅全球基金结核病项目办公室

出　　处：《现代预防医学》2009年第19期3601-3603,3605,共4页Modern Preventive Medicine

基　　金：第五轮全球基金结核病项目(CHN-506-G08-T);WHO合作项目(WP/2006/CHN/1.3/001)

摘　　要：[目的]了解河南地区结核(TB)病人群中艾滋病病毒(HIV)感染情况,为制订TB/HIV双重感染防治工作规划提供依据。[方法]采取WHO推荐的在结核病人中监测HIV感染的方案,采用整群分层抽样方法,以第五轮全球基金结核病项目县13个单位和根据2006年各县报告HIV感染情况另外抽取低疫情地区12个非项目县为调查点,对调查期内新登记的结核病人采用关联保密的方法,用酶联免吸附试验(ELISA)进行HIV初筛,初筛阳性者做免疫印迹(WB)确认试验,并进行问卷调查。[结果]新登记结核病人HIV受检率97.6%,HIV阳性率2.08%;结核病合并HIV感染者30～59岁组占86.2%;结核病合并HIV感染者中肺外结核占8.05%,痰涂片阳性占46%,CD4低于200个/MM3者占64.8%;、第五轮全球基金结核病项目地区结核病人中HIV阳性率、已知HIV阳性人数、转诊率、推荐率(2.89%、66、3.15%、5%)明显高于非项目地区(0.49%、3、0.9%、0);结核病合并HIV感染者中因血液传播占74.7%,因异性传播占8%。[结论]第五轮全球基金结核病项目地区结核病人中HIV感染处于中等流行水平,非项目地区结核病人中HIV感染处于低流行水平;HIV感染者中肺外结核、涂阴肺结核存在漏诊问题,应加强对双感染病人的诊断技术培训。[Objective ] To understand the state of HIV infection in patients of tuberculosis in Henan province, to set the prevention and cure program according as it. [Methods] The primary screening of HIV infection was done by ELISA, and final screening of HIV infection was taken by WB. The subjects investigated were cases of tuberculosis. [ Results] The rate of accepting inspect of HIV was 97.6%. the rate of HIV infection was 2,08% ; the lung tuberculosis combined with H/V rates of 30-59 years old was 86.2%, in which 8.05% was extrapulmonary tuberculosis. The positive rates of sputum smear （＋） was 46% in Tb/HIV, cases whose CD4 below 200/ MM3 was 64.8% ; In Round 5th TB Project of Global Fund item areas, positive rate of HIV infection, the number of positive HIV cases, transfer treatment rate and recommendation rate were 2.89%, 66. 3.15%, 5%. which were obviously higher than non-item areas （0.49%, 3, 0, 9%, 0） ; the hmg tuberculosis combined with HIV infected by blood was 74.7%, by opposite sex was 8%. [Conclusion] （ 1 ） The rate of HIV infection in patients of tuberculosis in item areas is medium, and the rate of HIV infection m patients of tuberculosis in non-item area is low. The extrapulmonary tuberculosis and sputum smear （-） pulmonary tuberculosis have missed diagnoses . The diagnosis technology should be enhanced.

关 键 词：结核 艾滋病病毒感染 

分 类 号：R52[医药卫生—内科学] R512.91[医药卫生—临床医学]