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High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China.

Journal article
Authors Rena Maimaiti
Yuexin Zhang
Kejun Pan
Peierdun Mijiti
Maimaitiali Wubili
Maimaitijiang Musa
Rune Andersson
Published in BMC infectious diseases
Volume 17
Issue 1
ISSN 1471-2334
Publication year 2017
Published at Institute of Biomedicine, Department of Infectious Medicine
Language en
Links dx.doi.org/10.1186/s12879-016-2152-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords HIV , tuberculosis, isoniazid prophylaxis, treatment outcome
Subject categories Infectious Medicine

Abstract

Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang.In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis.The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001).The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

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