Abstract
BackgroundAs one of the poorest provinces in China, Guangxi has a high HIV and TB prevalence, with the annual number of TB/HIV cases reported by health department among the highest in the country. However, studies on the burden of TB-HIV co-infection and risk factors for active TB among HIV-infected persons in Guangxi have rarely been reported.ObjectiveTo investigate the risk factors for active TB among people living with HIV/AIDS in Guangxi Zhuang autonomous region, China.MethodsA surveillance survey was conducted of 1 019 HIV-infected patients receiving care at three AIDS prevention and control departments between 2013 and 2015. We investigated the cumulative prevalence of TB during 2 years. To analyze risk factors associated with active TB, we conducted a 1:1 pair-matched case-control study of newly reported active TB/HIV co-infected patients. Controls were patients with HIV without active TB, latent TB infection or other lung disease, who were matched with the case group based on sex and age (± 3 years).ResultsA total of 1 019 subjects were evaluated. 160 subjects (15.70%) were diagnosed with active TB, including 85 clinically diagnosed cases and 75 confirmed cases. We performed a 1:1 matched case-control study, with 82 TB/HIV patients and 82 people living with HIV/AIDS based on surveillance site, sex and age (±3) years. According to multivariate analysis, smoking (OR = 2.996, 0.992–9.053), lower CD 4+ T-cell count (OR = 3.288, 1.161–9.311), long duration of HIV-infection (OR = 5.946, 2.221–15.915) and non-use of ART (OR = 7.775, 2.618–23.094) were independent risk factors for TB in people living with HIV/AIDS.ConclusionThe prevalence of active TB among people living with HIV/AIDS in Guangxi was 173 times higher than general population in Guangxi. It is necessary for government to integrate control planning and resources for the two diseases. Medical and public health workers should strengthen health education for TB/HIV prevention and treatment and promote smoking cessation. Active TB case finding and early initiation of ART is necessary to minimize the burden of disease among patients with HIV, as is IPT and infection control in healthcare facilities.
Highlights
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a severe public health problem around the world [1,2]
We performed a 1:1 matched case-control study, with 82 TB/HIV patients and 82 people living with HIV/AIDS based on surveillance site, sex and age (±3) years
The prevalence of active TB among people living with HIV/AIDS in Guangxi was 173 times higher than general population in Guangxi
Summary
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a severe public health problem around the world [1,2]. The rate of TB/HIV co-infection peaked in the 1990’s. The increased trend of TB/HIV co-infection is approximately 10% per year[4]. In 2014, almost 1.2 million cases (12.5%) of TB worldwide were associated with HIV infection, and TB accounts for an estimated 350,000 deaths among HIV-infected persons. Asia has a high-prevalence area of TB/HIV co-infection second to Africa[5]. As one of the poorest provinces in China, Guangxi has a high HIV and TB prevalence, with the annual number of TB/HIV cases reported by health department among the highest in the country. Studies on the burden of TB-HIV co-infection and risk factors for active TB among HIV-infected persons in Guangxi have rarely been reported
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