Abstract:

Objective To analyze the outcomes of anti-tuberculosis treatment in MTB/HIV co-infection patients, and to explore risk factors affecting the success of the treatment, and to provide scientific evidence for effective control of MTB/HIV co-infection. Methods A total of 2249 TB patients diagnosed and registered as MTB/HIV co-infection and receiving treatment at the TB designated hospitals from 2017 to 2019 were enrolled into this study. Patients with no cause or time to discontinue treatment, changes in diagnosis, single drug resistance or multidrug resistance were excluded, and 2158 cases were included. The data of the patients were collected, which included demographic characteristics (gender, age, nationality, occupation), patients detection methods (source of patients, institutional level of first seeking) and disease characteristic (complicated with other TB, severe disease, time of HIV positive test, etiological test results, drug resistance, treatment classification, years of AIDS diagnosis) and treatment outcomes. The factors affecting patients’ treatment outcomes were analyzed. Results Among 2158 MTB/HIV patients, 442 cases were cured and 1505 cases completed therapy, and the treatment success rate was 90.22% (1947/2158). The adverse outcome rate was 9.78% (211/2158), including 134 cases (6.21%) died from non-tuberculosis disease, 22 cases (1.02%) lost, 16 cases (0.74%) died from TB, 13 cases (0.60%) discontinued therapy due to adverse reactions, 7 cases (0.32%) of failure, 1 case (0.05%) conversed to multidrug-resistant TB treatment, and 18 cases (0.83%) of other treatment outcome. Multivariate analysis indicated that the risk factors affecting the success of the anti-TB therapy in patients were associated with first seeking institution level and TB diagnosis results of different categories of MTB/HIV patients. Compared with patients whose first seeking institution at municipal level, those who visited county level had a lower risk of adverse outcomes (OR=0.525, 95%CI: 0.288-0.955).Positive TB patients had a 1.433-fold higher risk of adverse outcome than negative TB patients and those without etiological results (OR=1.433, 95%CI:1.053-1.951). Conclusion The adverse outcomes rate of MTB/HIV patients with positive etiology tests and fist diagnosed in municipal medical institutions are relatively higher. It is necessary to strengthen the health education and curative effect observation of the patients who are first diagnosed in municipal medical institutions and have positive etiological examination results, and adjust the treatment regimen in time, so as to improve the treatment success rate of the patients with MTB/HIV and improve the prognosis of the patients.

Key words: HIV infection, Tuberculosis, Comorbidity, Treatment outcome, Factor analysis,statistics