2011—2020年长沙市MTB/HIV双重感染流行特征分析

目的: 分析长沙市MTB/HIV双重感染流行特征,以完善相关防控策略。方法: 从《结核病管理信息系统》和《TB/HIV双重感染防治管理工作年度报表》中提取2011—2020年长沙市MTB/HIV双感者相关资料,建立长沙市MTB/HIV感染特征分布综合数据库。分析MTB/HIV双重感染的检出情况,描述其随年度变化的趋势以及在不同时间、性别、年龄和地区的流行分布特征。结果: 2011—2020年,长沙市累计发现MTB/HIV双重感染者280例,患者发现率随年度呈波动性上升[4.29%(12/280)~15.36%(43/280)]。其中,在结核病患者中检出HIV感染者39例,年均检出率为0.10%(39/38990),不同年度HIV阳性检出率[0.03%(1/3759)~0.22%(9/4057)]呈波动性上升趋势(Z=2.347,P=0.019);在HIV/AIDS患者中检出MTB感染者241例,年均检出率为0.68%(241/35381),不同年度肺结核检出率[0.41%(19/4639)~2.13%(13/610)]呈波动性下降趋势(Z=-6.126,P=0.001)。在280例MTB/HIV双重感染者中,性别分布以男性为主[85.71%(240/280)];年龄分布以25~44岁年龄组为主[46.78%(131/280)],其次是45~64岁年龄组[32.50%(91/280)];地区分布以浏阳市为最多[26.07%(73/280)],其次为长沙县和宁乡市[均为16.43%(46/280)]。结论: 长沙市MTB/HIV双重感染水平较低,但在结核病患者中筛查HIV感染者的年均检出率呈波动上升趋势,在HIV/AIDS者中筛查MTB感染者的检出率呈波动下降趋势。应以男性、25~44岁年龄组以及AIDS及结核病疫情分布较高地区的人群为防控重点。

Epidemiological characteristics of MTB/HIV double infection in Changsha from 2011 to 2020

Objective: To analyze the epidemic characteristics of MTB/HIV double infection in Changsha, and to improve the prevention and control strategies. Methods: The data of MTB/HIV dual infection patients in Changsha from 2011 to 2020 were extracted from Tuberculosis Information Management System and TB/HIV Dual Infection Prevention and Management Annual Report, to establish a comprehensive database of MTB/HIV characteristics and distribution in Changsha. The detection of MTB/HIV dual infection, description of the annual change trend and the epidemic distribution characteristics in different time, gender, age and region were analyzed. Results: From 2011 to 2020, a total of 280 MTB/HIV double infection cases were found in Changsha, the patient detection rate fluctuated with the year (4.29% (12/280)-15.36% (43/280)). Among them, HIV infection were detected in 39 tuberculosis patients, with an annual detection rate of 0.10% (39/38990). The HIV positive rate showed an increasing trend of fluctuation in different years (0.03% (1/3759)-0.22% (9/4057))(Z=2.347, P=0.019). Among HIV/AIDS patients, MTB infection were detected in 241 cases, and the average annual detection rate was 0.68% (241/35381). The detection rate of tuberculosis showed a decreasing trend with fluctuation in different years (0.41% (19/4639)-2.13% (13/610))(Z=-6.126,P=0.001). The 280 MTB/HIV dual infected patients were mainly male (85.71% (240/280)); and the age was mainly at 25-44 years (46.78% (131/280)), followed by 45-64 years old (32.50% (91/280)). As to regional distribution, Liuyang City had the most cases (26.07% (73/280)), followed by Changsha County and Ningxiang City (both 16.43% (46/280)). Conclusion: The level of MTB/HIV double infection in Changsha was low, but the average annual detection rate of HIV infection among tuberculosis patients showed a fluctuating upward trend. The detection rate of MTB infection in HIV/AIDS screening showed a fluctuating downward trend. The prevention and control should be focused on male and 25-44 years age group, as well as people in areas with high prevalence of AIDS and tuberculosis.