Abstract:

Objective To analyze the MTB infection and its influencing factors in HIV/AIDS patients. Methods From January to July 2017, 3 community hospitals were selected by a random cluster sampling method in Changzhou, in which HIV/AIDS patients by the 10-year cumulative registration were used as the research subjects. As a result, a total of 475 subjects were included, with an average age (44.44±13.85) years, including 378 males (79.58%) and 97 females (20.42%); 273 HIV-infected patients (57.47%) and 202 AIDS patients (42.53%). The sociodemographic information and clinically relevant information of the subjects were collected. Peripheral venous blood from subjects was tested for HIV viral load, then the subjects with CD4 ⁺ T cell counts>200 cells/μl were selected for MTB infection detection using QuantiFERON ^®-TB Gold (QFT). The MTB infection status of the subjects was analyzed and influencing factors of MTB infection were analyzed by multivariate non-conditional logistic regression. Results There were 429 subjects with CD4 ⁺ T cell counts>200 cells/μl, and the MTB infection rate was 10.02% (43/429). Univariate analysis showed that the MTB infection rate of subjects with CD4 ⁺ T cell counts>200 cells/μl who had a history of tuberculosis exposure was higher than that of subjects without history of tuberculosis exposure (30.30%(10/33) vs. 8.33% (33/396); χ ²=16.30, P<0.05); and the MTB infection rate of subjects with CD4 ⁺ T cell counts >500 cells/μl was higher than that of subjects with CD4 ⁺ T cell counts from 200 to 500 cells/μl (13.15% (33/251) vs. 5.62% (10/178); χ ²=6.55, P<0.05). Further unconditional logistic regression analysis showed that among HIV/AIDS patients with CD4 ⁺ T cell counts>200 cells/μl, the risk of MTB infection in the subjects with history of tuberculosis exposure was 4.61 times of subjects without history of tuberculosis exposure (adjusted OR=4.61, 95%CI=2.00-10.63); and the MTB infection risk of HIV/AIDS patients with CD4 ⁺ T cell counts>500 cells/μl was 2.47 times of the HIV/AIDS patients with CD4 ⁺ T cell counts from 200 to 500 cells/μl (adjusted OR=2.47, 95%CI=1.17-5.21). Conclusion The detection rate of MTB infection is low in HIV/AIDS patients with low immune level. The history of tuberculosis exposure and immune level are important influencing factors of MTB infection in HIV/AIDS patients.

Key words: Mycobacterium tuberculosis, Infection, HIV infections, Acquired immunodeficiency syndrome, Comorbidity, Factor analysis,statistical