异烟肼预防性治疗HIV/TB双重感染者效果观察  

Study on INH preventive therapy for patients with HIV/TB co-infection

作　　者：赵丁源[1] 卢星星[1] 周丽平[1] 罗军民[1] 杨成凤[1] 刘勋[1] 叶建君[1] 

机构地区：[1]湖北省疾病预防控制中心,武汉430079

出　　处：《公共卫生与预防医学》2016年第2期42-45,共4页Journal of Public Health and Preventive Medicine

基　　金：世行贷款/英国赠款中国结核病控制项目"HIV/TB双重感染的流行规律及结核病化学预防效果的研究"(49)

摘　　要：目的探索采用异烟肼（INH）对PPD＋的HIV感染者/AIDS患者进行结核病预防性治疗的效果。方法对湖北省13个艾滋病疫情比较严重的县、区中能随访到的PPD＋的HIV感染者/AIDS患者进行9个月的INH预防性治疗,随访观察自愿服药者和拒绝服药者1年和5年后的结核发病情况。结果 213例PPD＋阳性HIV感染者中,166例自愿接受9个月INH预防性治疗,47例拒绝INH预防性治疗。自愿服药组和拒绝服药组1年结核发病率分别为0.60%和6.38%（χ^2=6.64,P〈0.05）,5年结核发病率分别为3.60%和17.02%（χ^2=10.72,P〈0.05）,5年结核死亡率分别为1.80%和14.89%（χ^2=14.02,P〈0.05）。结论 INH预防性治疗能有效降低HIV/TB双重感染者结核病发病率,但仍需探讨HIV/AIDS患者中活动性肺结核的诊断,以及PPD低阳性率等问题。Objective To explore the effect of INH preventive therapy on patients with HIV（ ＋） / AIDS and PPD ＋. Methods Patients with HIV ＋ / AIDS and PPD ＋ were given 9 months of INH preventive therapy in 13 counties and districts of Hubei Province,where the epidemic situation of AIDS was rather serious. The therapy group voluntarily took INH and the control group rejected to take INH,they were followed up to observe the incidence of tuberculosis in the following 5 years. Results 166 of 213 cases with HIV ＋PPD ＋ receiced 9- month INH treatment,while 47 cases refused. The tuberculosis incidence rates of voluntary therapy group and control group in the first year of following up were 0. 60% and 6. 38% respectively（ χ~2= 6. 64,P 0. 05）,however,they were 3. 60%and 17. 02% respecrtively at the fifth year of following up（ χ~2= 10. 72,P 0. 05）. The tuberculosis mortality rates at the fifth year of follow-up of voluntary therapy group and control group were 1. 80% and 14. 89% respectively. Conclusion INH preventive therapy could effectively reduce the morbidity of tuberculosis in patients with HIV and TB co-infection,it is necessary to think over about the diagnosis of active pulmonary tuberculosis in patients with HIV / TB co-infection,and the low positive rate of PPD,etc.

关 键 词：预防性治疗 异烟肼 HIV感染 PPD阳性 结核病 

分 类 号：R512.9[医药卫生—内科学]