广西2007－2012 年结核分枝杆菌和艾滋病病毒联合感染患者死亡特征分析

郑志刚; 唐振柱; 林玫; 刘飞鹰; 崔哲哲; 耿文奎

Abstract

郑志刚,唐振柱,林玫,刘飞鹰,崔哲哲,耿文奎.广西2007－2012 年结核分枝杆菌和艾滋病病毒联合感染患者死亡特征分析[J].Chinese journal of Epidemiology,2014,35(6):695-698

广西2007－2012 年结核分枝杆菌和艾滋病病毒联合感染患者死亡特征分析

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi，from 2007 to 2012

Received:December 12, 2013

DOI：

KeyWord: 艾滋病结核病联合感染死亡

English Key Word: HIV/AIDS Tuberculosis Co-infection Death

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Author Name	Affiliation	E-mail
Zheng Zhigang	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Tang Zhenzhu	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Lin Mei	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Liu Feiying	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Cui Zhezhe	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Geng Wenkui	Guangxi Zhuang Autonomous Region Health Authority	gxnngengwk@163.com

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Abstract:

目的了解2007－2012 年广西结核分枝杆菌（MTB）/HIV 联合感染患者死亡特征，为有效控制联合感染提供科学依据。方法收集整理2007－2012 年广西死因登记系统（VRS）中根本死因为HIV造成MTB感染死亡的个案及死因诊断为结核病（TB）的患者，核对病例在TB专报系统的实验室检测结果、诊断时间、发病时间等信息;用统计学方法统计分析病例的三间分布、死亡平均年龄、从发病到死亡时间间隔等特征。结果 2007－2012 年广西VRS登记的HIV 死亡患者中，203 例因感染MTB死亡，MTB/HIV联合感染死亡患者占同期AIDS、TB死亡患者的平均比例为8.24%（3.94%～13.27%）和9.90%（2.56%～26.88%）。2010－2012 年，MTB/HIV 死亡患者占同期AIDS、TB死亡患者的平均比例上升到10.66%和22.17%;MTB/HIV 联合感染死亡患者男女比例为4.21 ∶ 1;平均死亡年龄为44.65（44.65±15.52）岁;从TB发病到诊断时间M为37（94.31±206.07）d;从诊断到死亡平均间隔M为46（165.22±282.19）d;54.68%的MTB/HIV患者在诊断TB2 个月内死亡;从发病到死亡时间M为131（257.68±340.79）d;16.26%的联合感染死亡患者被细菌学确诊为TB病例。结论细菌学确诊的MTB/HIV患者比例少于HIV阴性TB患者;而MTB导致的联合感染死亡患者占同期AIDS、TB死亡比例较大，且近3 年增加明显，需要增加抗病毒治疗覆盖面;大部分联合感染患者诊断TB后很快死亡，应尽早在HIV患者中发现TB患者。

English Abstract:

Objective To understand the general feature of patients with Mycobacterium tuberculosis（MTB）and human immunodeficiency virus（HIV）co-infectious（TB/HIV）in Guangxi， from 2007 to 2012. Methods Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System，together with bacterium smear or culture results，onset of TB，time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death，age，occupation，the underlying cause of death among TB patients， bacterium distribution，average age of death，interval from onset to death，percentage of TB/HIV co-infection patients among all the patients etc，were all analysed. Results 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24%（ranging from 3.94% in 2007 to 13.27% in 2012）among all the deaths of HIV infection while it accounted for 9.90% （ranging from 2.56% to in 2007 to 26.88% in 2012）among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66%（ranging from 8.83% to 13.27%）and 22.17%（ranging from 20.60% to 26.88%）among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1，with the average age of death as 44.65 （44.65 ± 15.52）years;median time from TB symptoms onset to diagnosis as 37（mean 94.31，standard deviation 206.07）days，record as（94.31±206.07）;median time from diagnosis to death as 46（165.22±282.19）days，54.68% TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 （257.68 ± 340.79） days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases. Conclusion Compare to those TB patients without HIV，less bacterium evidence was found in TB/ HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years，suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

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