南宁市农村地区结核病患者HIV感染状况分析  

Analysis of HIV Infection in Tuberculosis Patients in Rural Areas of Nanning City

作　　者：何波[1] 农丽萍[1] 黎舒[1] 陈文才[1] 农梦妮 岑平[1] 林倩[1] 姚敏[1] 李斯斯[1] HE Bo;NONG Liping;LI Shu;CHEN Wencai;NONG Mengni;CEN Ping;LIN Qian;YAO Min;LI Sisi(Nanning City Center for Disease Control and Prevention in Guangxi,Nanning 530023,China)

机构地区：[1]广西南宁市疾病预防控制中心,广西南宁530023

出　　处：《中国皮肤性病学杂志》2019年第5期553-559,共7页The Chinese Journal of Dermatovenereology

基　　金：广西卫生和计划生育委员会科研课题(Z20180347);广西卫生和计划生育委员会科研课题(Z20181042);南宁市科技局科研课题(20163112)

摘　　要：目的了解南宁市农村地区结核病(TB)患者中艾滋病病毒(HIV)感染情况,为今后的防治工作提供科学依据。方法 2015-2017年在南宁市所辖的县级结核病防治机构门诊对新登记的结核病患者进行HIV抗体初筛,初筛阳性者标本送市级疾病预防控制中心进行确证,并按照年份、不同县等人口学特征进行分析。结果 2015-2017年南宁市所辖的4个县级结核病防治机构门诊共诊断登记TB患者5 031例,TB患者中HIV抗体检测率为88.33%(4 444/5 031)。其中查出HIV抗体阳性29例,HIV感染率为0.65%(29/4 444),各年间的差异无统计学意义(χ~2=5.493,P>0.05)。按县分布看,LA县HIV感染率最高(1.11%),但各县之间的差异无统计学意义(χ~2=4.752,P>0.05)。TB/HIV双重感染患者的传播途径以异性性接触传播为主。多因素分析显示:50岁及以上年龄段(OR=2.823, 95%CI:1.332～5.991)、治疗结局为死亡者(OR=7.832, 95%CI:3.951～7.817)是结核病患者感染HIV的危险因素(OR>1),女性(OR=0.661, 95%CI:0.588～0.744)是合并HIV感染率低(OR<1)。结论南宁市农村地区结核病患者的HIV感染率处于中等水平;50岁及以上中老年男性人群是TB/HIV双重感染防治工作的重点关注对象;应进一步加强结核病患者HIV筛查监测和宣传干预工作,尽早发现、规范治疗和管理TB/HIV双重感染患者,减少结核病/艾滋病的感染和传播。Objective To study HIV infection in tuberculosis(TB)patients in rural areas of Nanning city in order to provide scientific basis for the prevention and treatment in the future.Methods From 2015 to 2017,HIV antibody screening was carried in new registered TB patients in the county tuberculosis clinics,and HIV positive samples were further verified by the municipal disease prevention and control center.Epidemiological methods were used to analyze the demographic characteristics of HIV infection.Results Out of 5 031 registered TB patients,4 444 cases(88.33%)received HIV antibody screen.A total of 29 patients(0.65%)were HIV antibody-positive.The highest positive rate was found in LA county(1.11%).HIV infection rates did not differ significantly either among the years(χ^2=5.493,P>0.05)or the counties(χ^2=4.752,P>0.05).Co-infections of TB/HIV were mainly transmitted by heterosexual contact.Logistic regression analysis showed that the risk factors of co-infections of TB/HIV were patients′aged≥50 years(OR=2.823,95%CI:1.332~5.991)and treatment outcome of death(OR=7.832,95%CI:3.951~7.817).On the other hand,females displayed lower rate of TB/HIV co-infections(OR=0.661,95%CI:0.588~0.744).Conclusion The HIV infection rate in TB patients is at medium level in rural areas of Nanning.Prevention and treatment of TB/HIV co-infection should be focused on males≥50 years of age.Management approaches of TB/HIV co-infection include routine HIV screening,public health education,monitoring,earlier diagnosis and intervention of TB and HIV infections.

关 键 词：结核病 艾滋病病毒 双重感染 农村地区 

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