林淑芳, 周银发, 陈代权, 陈堃, 陈江芬, 戴志松. 人类免疫缺陷病毒阳性与阴性肺结核患者流行特征及治疗转归对比分析[J]. 疾病监测, 2023, 38(12): 1526-1529. DOI: 10.3784/jbjc.202209070396
引用本文: 林淑芳, 周银发, 陈代权, 陈堃, 陈江芬, 戴志松. 人类免疫缺陷病毒阳性与阴性肺结核患者流行特征及治疗转归对比分析[J]. 疾病监测, 2023, 38(12): 1526-1529. DOI: 10.3784/jbjc.202209070396
Lin Shufang, Zhou Yinfa, Chen Daiquan, Chen Kun, Chen Jiangfen, Dai Zhisong. Epidemiological characteristics and treatment outcome of pulmonary tuberculosis with or without human immunodeficiency virus[J]. Disease Surveillance, 2023, 38(12): 1526-1529. DOI: 10.3784/jbjc.202209070396
Citation: Lin Shufang, Zhou Yinfa, Chen Daiquan, Chen Kun, Chen Jiangfen, Dai Zhisong. Epidemiological characteristics and treatment outcome of pulmonary tuberculosis with or without human immunodeficiency virus[J]. Disease Surveillance, 2023, 38(12): 1526-1529. DOI: 10.3784/jbjc.202209070396

人类免疫缺陷病毒阳性与阴性肺结核患者流行特征及治疗转归对比分析

Epidemiological characteristics and treatment outcome of pulmonary tuberculosis with or without human immunodeficiency virus

  • 摘要:
    目的 通过分析福建省登记的人类免疫缺陷病毒( HIV)阳性与HIV阴性的肺结核(PTB)患者流行特征、抗结核治疗转归及其影响因素情况,为制定和完善HIV阳性PTB的预防和控制政策提供参考依据。
    方法 从“中国疾病预防控制信息系统”中收集2012—2021年福建省登记的PTB患者信息,采用χ2检验分析PTB患者流行特征与治疗转归差异,采用单因素和多因素logistic回归分析抗结核治疗未成功的危险因素,以P<0.05为差异有统计学意义。
    结果 HIV阳性PTB患者中男性占比、年龄<60岁、农民工占比以及本地户籍占比高于HIV阴性PTB患者,差异具有统计学意义(相应的χ2值分别为37.365、4.775、22.448和22.826,均P<0.05)。 HIV阳性PTB患者中治疗分类为复治和病原学检查结果为阳性占比均低于HIV阴性PTB患者,差异具有统计学意义(相应的χ2值分别为7.443和21.250,均P<0.05)。 HIV阳性PTB患者抗结核成功治疗率(86.4%)明显低于HIV阴性PTB患者(91.7%),差异具有统计学意义(χ2=12.441,P<0.05)。 HIV阳性PTB患者出现抗结核治疗未成功危险是HIV阴性PTB患者的1.999倍(比值比=1.999,95%可信区间:1.448~2.759)。
    结论 男性、职业为农民工或户籍为本地的PTB患者合并HIV感染的概率更大,而病原学阳性或治疗分类为复治的PTB患者合并HIV感染的概率更小。 合并HIV感染是PTB患者抗结核治疗未成功的独立危险因素。

     

    Abstract:
    Objective To analyze the epidemiological characteristics, treatment outcome and its influencing factors of pulmonary tuberculosis (PTB) with or without human immunodeficiency virus (HIV) and provide evidence for developing more effective TB control strategies.
    Methods The information of PTB patients registered in Fujian province from 2011 to 2020 was collected from China National TB Surveillance System. Differences between PTB with and without HIV-positive individuals were analyzed by Chi-square testing. Univariate and multivariate risk factors for unsuccessful anti-TB therapy were analyzed by logistic regression ,with P<0.05 considered statistically significant. Results The proportion of men, migrant workers and local households with HIV positive was higher than HIV negative (χ2-values were 37.365, 4.775, 22.448 and 22.826, respectively, P<0.05). However, among HIV-positive PTB patients, the proportion of initial treatment and bacteriological diagnosis was lower than in HIV-negative PTB patients (χ2-values were 7.443 and 21.250, respectively, P<0.05). The rate of successful treatment in PTB with HIV-positive (86.4%) was higher than in PTB with HIV-negative (91.7%) (χ2=12.441, P<0.05). The risk of unsuccessful anti-TB treatment in HIV positive PTB patients was 1.999 times greater than that of HIV negative PTB patients (OR=1.999, 95%CI: 1.448−2.759).
    Conclusion PTB with characteristics of men, migrant workers or local households were more likely to co-infect HIV, while those with characteristics of initial treatment or bacteriological diagnosis were less likely to co-infect HIV. Co-infection with HIV was an independent risk factor for unsuccessful anti-TB therapy in PTB patients.

     

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