Risk factors associated with Tuberculosis (TB) among people living with HIV/AIDS: A pair-matched case-control study in Guangxi, China

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.

Types and prevalence of HIV-related opportunistic infections/conditions among HIV-positive patients attending Kenyatta National Hospital in Nairobi, Kenya

“…Patients with CD4 counts of 0-199 or 200-349 had approximately 2 times higher odds of having TB infection. This has also been seen in other studies and is known to occur as a result of loss of CD4 cells and impairment of the immune system in HIV [19][20][21] .…”

Decline in the incidence of tuberculosis among HIV-infected patients enrolled in HIV care, treatment and support programme from 2011 to 2014 in Mainland Tanzania

“…As observed in this analysis and reported in other studies, the use of ART has great advantage on reduction of incidence of TB, evidenced by marked low incidence of TB among persons on ART compared to those not on ART [16,24,25]. The findings are conceivable because the TB infection and reactivation has been associated with the degree of immune suppression which improve after start of ART [26].…”

Diagnósticos de enfermagem da CIPE® para pessoas com Síndrome da Imunodeficiência Adquirida

“…The consequence is an impaired environmental ventilation. (14) Another important point is that the disease makes lung cells produce a mucous substance that hinders the normal ventilation process. (15) Given this condition, it is necessary that the nursing team acts by performing interventions, such as decubitus change, postural drainage and cough stimulation to promote respiratory rehabilitation, so that patients reach the physiological parameters of 12-20 respiratory incursions per minute.…”

“…(15) Given this condition, it is necessary that the nursing team acts by performing interventions, such as decubitus change, postural drainage and cough stimulation to promote respiratory rehabilitation, so that patients reach the physiological parameters of 12-20 respiratory incursions per minute. (14,15) In the field of vascular regulation need, the diagnosis was impaired vascular perfusion. The causes can be multifactorial, but the most common are anemia, resulting from the use of antiretroviral drugs, or nutritional deficiency, which leads to capillary fragility and changes the whole reticulo-endothelial system.…”

“…In people living with AIDS, this property is influenced by the deficient immunocompetence, which makes them vulnerable to infection and submit them to the risks inherent to a hospital stay, such as the inadequate use of antibiotic therapy and the execution of invasive procedures (for instance, non-observation of the aseptic technique and unnecessary interventions) that can threaten patients' lives and boost new infections. (8)(9)(10)(11)(12)(13)(14)(15) In people living with AIDS, impaired swallowing is most commonly caused by candidiasis, a fungal infection provoked by yeast from the Candida genus. It affects the oropharynx cavity and the esophagus.…”