3省艾滋病病毒感染对结核病控制影响  

Impact of HIV infection on tuberculosis control in three provinces

作　　者：赖钰基[1] 成诗明[1] 周林[1] 刘二勇[1] 王冬梅[1] 李涛[1] 

机构地区：[1]中国疾病预防控制中心结核病预防控制中心,北京102206

出　　处：《中国公共卫生》2013年第12期1738-1741,共4页Chinese Journal of Public Health

基　　金："中国艾滋病和结核病多学科应用培训项目"给予的技术支持

摘　　要：目的分析艾滋病病毒(HIV)感染对结核病发病和抗结核治疗效果带来的影响及其相关因素。方法从结核病信息管理系统中导出3省9个县2007年9月1日—2009年8月31日12 516例结核病患者患病和治疗的相关信息,从艾滋病防治机构收集HIV阳性患者的艾滋病相关信息,比较HIV阳性和阴性患者的患病特征和抗结核治疗效果。结果与12 069例HIV阴性患者比较,447例HIV阳性患者痰涂片阴性比例较高(68.5%vs36.4%,χ2=188.46,P<0.01)、肺部出现空洞的比例相对较低(3.8%vs 11.0%,χ2=23.18,P<0.01)、治疗成功率较低(89.0%vs 96.1%,χ2=54.86,P<0.01)、非结核死亡率较高(8.3%vs 0.7%,χ2=261.48,P<0.01);诊断肺结核时CD4<200个/μL和未接受抗病毒治疗的HIV阳性患者死亡风险较高。结论艾滋病的流行给结核病的诊断和治疗效果带来了负面影响,及早发现HIV阳性的结核病患者并给予抗结核和抗病毒治疗,有助于降低患者的病死率。Objective To analyze the impact of human immunodeficiency virus（HIV）infection on clinical characteristics of tuberculosis（TB）,anti-TB treatment outcome and related factors.Methods We collected TB-related information from TB information management system and HIV-related information from HIV institutions.We selected nine counties from three provinces and surveyed a total of 12 516 TB cases registered between September 2007 and August 2009.We compared the characteristics of TB prevalence and anti-TB treatment outcome between HIV-positive and HIV-negative TB patients.Results Compared to 12 069 HIV-negative cases,447 HIV-positive cases had a higher percentage of sputum smear negative（68.5% vs 36.4%,χ2=188.46;P〈0.01）,a lower percentage of cavity in chest（3.8% vs 11.0%,χ2=23.18;P〈0.01）,a lower percentage of successful treatment rate（89.0% vs 96.1%,χ2=54.86;P〈0.01）,and a higher percentage of non-TB related death rate（8.3% vs 0.7%,χ2=261.48;P〈0.01）.The TB patients with CD4〈200 and without anti-retrovirus treatment had a higher risk of death.Conclusion HIV epidemic has negative impact on TB diagnose and treatment.To detect HIV-positive TB patients earlier and to implement related-treatment in time could decrease the fatality rate of HIV-positive TB patients.

关 键 词：结核病 治疗结果 艾滋病 双重感染 

分 类 号：R512.91[医药卫生—内科学]