九江地区HIV合并TB感染流行病学调查及用药分析

Epidemiological investigation and medication analysis of HIV complicated TB infection in Jiujiang area

目的探讨人类免疫缺陷病毒(HIV)合并结核病(TB)感染的流行病学特征及用药情况。方法选取2019年6月至2020年12月于九江市第三人民医院就诊的HIV合并TB感染患者79例进行调查,统计婚姻状况、性别、是否吸毒等资料,采用多因素logistic分析影响HIV合并TB感染的危险因素,并分析用药情况。结果单因素分析结果显示,不同年龄、学历、感染途径、CD4+细胞数及是否知晓TB是AIDS的常见机会性感染之一的患者比较,差异有统计学意义(P<0.05)。多因素分析结果显示,年龄、学历、感染途径、CD4+细胞数及是否知晓TB是AIDS的常见机会性感染之一是HIV合并TB感染的独立危险因素(P<0.05)。HIV合并TB感染对8种药物的耐药率由高到低分别为异烟肼、利福平、吡嗪酰胺、左氧氟沙星、丙硫异烟胺、利福喷丁、对氨基水杨酸钠、乙胺丁醇。结论应加大低学历、高龄人群的HIV合并TB筛查工作,针对耐药情况合理使用药物进行治疗。

Objective To investigate the epidemiological characteristics and drug use of human immunodeficiency virus(HIV)combined with tuberculosis(TB)infection.Methods A total of 79 patients with HIV complicated with TB infection in Jiujiang Third People′s Hospital from June 2019 to December 2020 were selected for investigation,and the data of marital status,gender and drug abuse were analyzed.The risk factors of HIV complicated with TB infection were analyzed by multivariate logistic analysis,and drug use was analyzed.Results Univariate analysis showed that there were statistically significant differences among patients with different age,education background,infection route,NUMBER of CD4+cells and whether they knew TB was one of the common opportunistic infections of AIDS(P<0.05).Multivariate analysis showed that age,educational background,infection route,CD4+cell count and whether TB is one of the common opportunistic infections of AIDS were independent risk factors for HIV with TB infection(P<0.05).The drug resistance rates of HIV combined with TB infection to eight drugs from high to low were Isoniazid,Rifampicin,Pyrazinamide,Levofloxacin,Protionamide,Rifapentine,Sodium Aminosalicylate,Ethambutol respectively.Conclusion It is necessary to increase the screening of HIV and TB among the low-educated and older people,and use drugs for treatment in response to drug resistance.