HIV合并结核感染的流行病学特征和相关影响因素

Epidemioiogical investigation of HIV and TB coinfection and influence factors

目的研究人类免疫缺陷病毒（humam immunodenciency virus，HIV）感染者中合并结核（tuberculosis，TB）感染的流行病学特征和相关影响因素。方法对1139例HIV感染者或艾滋病（AIDS）病人，用统一的调查表了解其流行病学一般情况，行痰涂片、X光胸片检查、PPD皮试、TB抗体以及血沉等检测，部分病人做了痰培养或病理检查。对1023例结核病人进行HIV抗体检测，用SPSS软件对不同因素对HIV合并TB感染或TB合并HIV感染的影响情况进行相关性分析。结果本组HIV合并TB的感染率为25．20％；静脉吸毒传播的HIV感染者合并的TB发病率明显高于性传播的HIV感染者（33．62％vs18．61％，）（χ2=31．63，P〈0．01），CD4^＋T细胞计数≤200个／μl的AIDS病人其TB发病率明显高于其它组（35．93％VS23．55％，χ2=11．42，P〈0．01；35．93％vs21．80％，χ2=42．37，P〈0．01）。住院TB患者中HIV抗体的检出率为1．56％。不同年龄组和不同职业的结核患者其抗HIV检出率差异无统计学意义（P〉0．05）；有吸烟史或其它慢性肺部疾病史的结核患者中HIV的检出率比无该类病史的患者更高。结论本组HIV合并TB感染率25．20％，静脉吸毒传播者和CD4^＋T细胞〈200个／μl的HIV—AIDS合并结核感染的发病率较高。有吸烟史或肺部感染史的结核患者，HIV抗体的检出率较高。

Objective To investigate epidemiological characters of tuberculosis in the patients with human immunodeficiency virus （HIV） and influence factors related to coinfeetion. Methods 1139 patients infected HIV who filled in epidemiological questionnaire and took sputum smear test, sputum culture, TB antibody test, PPD skin test, ESR, chest X-ray and/or pathological examination were enrolled in this study. HIV antibody test was performed on 1023 TB hospital patients. SPSS software was used to do statistical anal- ysis. Results Coinfection rate of HIV and TB was 25.20% in HIV/AIDS, and 1.56% in TB patients. The coinfection rate in intravenous drug users was higher than that in the patients infected through sex （33.62% VS18.61%, χ2 =31.63, P 〈 0. 01 ）. And it was higher in AIDS patients with C D4 ＋T count ≤ 200 cellμl than in other patients（35.93% vs 23.55% ,χ2 = 11. 42, P 〈0. 01 ;35.93 vs 21.80% ,χ2 = 42. 37, P 〈 0.01 ）. HIV positive rate in TB patients with history of smoking or other lung disease was 3.1% , which was higher than other patients without those history. Conclusion The coinfection rate in intravenous drug users was higher than that in patients infected through sex. The coinfection rate of AIDS patients with CD4 ＋T count ≤200 cell / μ1 was higher than other patients. HIV positive rate in TB patients with history of smoking or other lung disease was higher than other patients without that history.