结核病患者人类免疫缺陷病毒感染的检测

Detection of human immunodeficiency virus infection in tuberculosis patients

目的人类免疫缺陷病毒（ＨＩＶ）和结核分支杆菌（ＭＴＢ）双重感染已引起广泛关注。通过对住院肺结核患者ＨＩＶ检测，了解住院肺结核患者中ＨＩＶ感染及艾滋病（ＡＩＤＳ）发病状况。方法对２９７３例住院肺结核患者常规采用明胶颗粒凝集试验法或ＨＩＶ１＋２抗体金标快速测试法进行初筛，阳性者抽血复测，并由北京市检测中心确定。结果２９７３例中ＨＩＶ（＋）３例，阳性率１．０１‰。男２例，女１例。年龄分别为２３、４０、２７岁，平均年龄３０岁，占２１～４０岁年龄组的２．８６‰。通过静脉吸毒血源性感染１例，异性间性乱２例。３例均已发展为ＡＩＤＳ。结论结核病防治工作者对ＨＩＶ／ＭＴＢ双重感染的危险性要有充分认识与高度重视。对具有ＨＩＶ感染危险因素的肺结核患者，特别是其中的中青年患者应常规进行ＨＩＶ抗体检测，有助于ＡＩＤＳ的早期发现、治疗。

Objective Combined infection of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) has attracted wide attention. This study was to find out infection of HIV and occurrence of AIDS in tuberculosis patients. Methods Primary screening was conducted in 2 973 inpatients with pulmonary tuberculosis by gelatin particle agglutination assay or rapid gold labeled HIV 1+2 antibody assay. The HIV positive cases were sent to Beijing Municipal Center Laboratory for verification. Results Three HIV positive cases were detected among 2 973 pulmonary tuberculosis patients with the positive rate of 1.01‰. Two were male and 1 female with average age of 30 years (23, 27, and 40 years respectively) accounting for 2.86‰ of the 21～41 age group, among which 1 infected through intravenous drug injection, 2 by heterosexual behavior. And all the 3 HIV positive cases had developed to be AIDS. Conclusions Enough knowledge of the risk of combined HIV/MTB infection and high degree alert should be emphasized in medical professionals involving in diagnosis, treatment and management of tuberculosis. Routine HIV antibody detection in high risk tuberculosis patients for HIV infection, especially in young and middle age tuberculosis patients, is helpful for early diagnosis and treatment of AIDS and avoiding its spreading.