Analysis on the current status and trend of MTB/HIV co-infection screening in Zhejiang Province from 2015 to 2021

doi:10.19983/j.issn.2096-8493.20220132

Abstract

Abstract:

Objective: To analyze the screening of MTB/HIV co-infection in Zhejiang Province from 2015 to 2021, so as to provide scientific basis for formulating and adjusting corresponding prevention and control policies. Methods: The relevant data of MTB/HIV co-infection in Zhejiang Province from 2015 to 2021 were collected from the Annual Report of Prevention and Management of MTB/HIV co-infection in Zhejiang Province. Excel 2010 software was used to organize and calculate the data. JoinPoint software was used to identify the inflection points of double infection detection rate and positive rate. ArcGIS 10.8 software was used to draw the spatial distribution map and visualize the results. R software was used to compare the differences between groups. Results: A total of 773 patients with double infection were found in Zhejiang Province from 2015 to 2021,771 patients (99.74%, 771/773) were over 15 years old, 90.94% (703/773) of the patients received tuberculosis treatment. Jinhua and Wenzhou were the areas with high incidence of double infection in Zhejiang Province, numbers of patients were 149 and 146, respectively. The detection rate of HIV screening in tuberculosis patients increased in the past seven years (APC=4.9, P<0.05), while the positive detection rate in HIV/AIDS patients showed a trend of decrease (APC=-15.5, P<0.05). Conclusion: The MTB/HIV co-infection screening in Zhejiang Province from 2015 to 2021 has a certain effect on the early detection and treatment of patients with co-infection. The screening rate of tuberculosis among HIV/AIDS patients should be improved, Jinhua and Wenzhou should strengthen the prevention and control of co-infection epidemic situation according to local conditions.

Key words: Mycobacterium tuberculosis, HIV infections, Comorbidity, Epidemiological studies

CLC Number:

Luo Dan, Chen Songhua, Zhang Yu, Wang Wei, Wu Qian, Wu Yonghao, Liu Kui, Chen Bin. Analysis on the current status and trend of MTB/HIV co-infection screening in Zhejiang Province from 2015 to 2021[J]. Journal of Tuberculosis and Lung Disease , 2022, 3(6): 443-448. doi: 10.19983/j.issn.2096-8493.20220132

Figures/Tables 6

References 15

[1]	Glaziou P, Floyd K, Raviglione MC. Global Epidemiology of Tuberculosis. Semin Respir Crit Care Med, 2018, 39(3): 271-285. doi:10.1055/s-0038-1651492. doi: 10.1055/s-0038-1651492 URL pmid: 30071543
[2]	Hemelaar J, Elangovan R, Yun J, et al. Global and regional molecular epidemiology of HIV-1, 1990—2015: a systematic review, global survey, and trend analysis. Lancet Infec Dis, 2019, 19(2): 143-155. doi:10.1016/S1473-3099(18)30647-9. doi: 10.1016/S1473-3099(18)30647-9 URL
[3]	World Health Organization. Global tuberculosis report 2021. Geneva: World Health Organization, 2021.
[4]	Teng VYM, Chua YT, Lai EEN, et al. Lack of latent tuberculosis (TB) screening and delay in anti-retroviral therapy initiation in HIV-TB co-infection: an 11-year study in an intermediate TB-burden country. Int J Infect Dis, 2021, 113: 178-183. doi:10.1016/j.ijid.2021.09.048. doi: 10.1016/j.ijid.2021.09.048 URL
[5]	Bell LCK, Noursadeghi M. Pathogenesis of HIV-1 and Mycobacterium tuberculosis co-infection. Nat Rev Microbiol, 2018, 16(2): 80-90. doi:10.1038/nrmicro.2017.128. doi: 10.1038/nrmicro.2017.128 URL
[6]	李雨薇, 李侠. 艾滋病/结核病双重感染流行现状与研究进展. 中外医学研究, 2022, 20(16): 181-184. doi:10.14033/j.cnki.cfmr.2022.16.046. doi: 10.14033/j.cnki.cfmr.2022.16.046 URL
[7]	中华人民共和国国家卫生和计划生育委员会. WS 288— 2017 肺结核诊断. 2017-11-09.
[8]	中华人民共和国国家卫生健康委员会. 艾滋病和艾滋病病毒感染诊断. 2019-01-02.
[9]	舒薇, 孙玙贤, 张立杰. 结核病的研究与创新——2021年世界卫生组织全球结核病报告解读. 中国防痨杂志, 2022, 44(1): 45-48. doi:10.19982/j.issn.1000-6621.20210685. doi: 10.19982/j.issn.1000-6621.20210685 URL
[10]	World Health Organization. WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders. Geneva: World Health Organization, 2012.
[11]	毛阿燕, 杨玉洁, 都率. 北京市疾控机构专业技术人员新冠肺炎疫情防控期间岗位分布及能力建设需求分析. 中国公共卫生, 2022, 38(6): 719-723. doi:10.11847/zgggws1136648. doi: 10.11847/zgggws1136648 URL
[12]	曹红, 邓晓岚, 钱冰. 2014—2019年合肥市MTB/HIV双重感染防治情况分析. 中国防痨杂志, 2021, 43(8): 803-807. doi:10.3969/j.issn.1000-6621.2021.08.009. doi: 10.3969/j.issn.1000-6621.2021.08.009 URL
[13]	饶立歆, 肖筱, 陈静. 结核病与艾滋病低流行地区MTB/HIV双重感染患者发现模式的效果评价. 中国防痨杂志, 2021, 43(3): 240-247. doi:10.3969/j.issn.1000-6621.2021.03.009. doi: 10.3969/j.issn.1000-6621.2021.03.009 URL
[14]	周银发, 戴志松, 陈代权. 福建省2016—2020年TB/HIV双重感染筛查情况分析. 海峡预防医学杂志, 2021, 27(6): 29-31.
[15]	徐云, 潘晓红, 郑锦雷. 2015年浙江省艾滋病疫情估计. 疾病监测, 2017, 32(2): 118-122. doi:10.3784/j.issn.1003-9961.2017.02.009. doi: 10.3784/j.issn.1003-9961.2017.02.009 URL

年份	本年度新检出HIV/AIDS患者			既往HIV/AIDS患者			检测率比较		检出率比较
年份	登记例数	检测例数 (检测率,%)	检出例数 (检出率,%)	随访例数	检测例数 (检测率,%)	检出例数 (检出率,%)	χ²值	P值	χ²值	P值
2015	3999	3750(93.77)	49(1.31)	12204	11332(92.85)	36(0.32)	3.806	0.051	47.430	<0.001
2016	4135	4008(96.93)	55(1.37)	14987	14394(96.04)	51(0.35)	6.770	0.009	54.960	<0.001
2017	4970	4752(95.61)	52(1.09)	18817	17972(95.51)	54(0.30)	0.077	0.781	49.310	<0.001
2018	4641	4399(94.79)	68(1.55)	22869	21553(94.25)	40(0.19)	2.007	0.157	159.800	<0.001
2019	4479	4289(95.76)	36(0.84)	26198	25004(95.44)	60(0.24)	0.813	0.367	38.450	<0.001
2020	4050	3784(93.43)	55(1.45)	29433	28716(97.56)	39(0.14)	211.800	<0.001	196.800	<0.001
2021	4057	3857(95.07)	34(0.88)	32707	30631(93.65)	37(0.12)	12.250	<0.001	92.830	<0.001

指标	趋势	APC (95%CI)值	t值	P值
HIV/AIDS患者中结核病检测率	上升	0.1(-0.7~1.0)	0.346	0.743
HIV/AIDS患者中结核病检出率	下降	-15.5(-19.2~11.6)	-9.528	<0.001
结核病患者中HIV抗体检测率	上升	4.9(2.5~7.3)	5.423	0.003
结核病患者中HIV抗体阳性率	下降	-12.4(-25.1~2.4)	-2.186	0.080

年份	登记例数	已知HIV阳性例数	接受本次检测例数	本次检测阳性例数	检测率 (%)	阳性率 (%)
2015	30344	52	10405	17	34.35	0.16
2016	29139	48	10811	20	37.16	0.18
2017	29317	63	11618	25	39.71	0.22
2018	28274	57	10948	12	38.80	0.11
2019	27223	76	12385	10	45.62	0.08
2020	24753	66	11145	15	45.15	0.13
2021	24394	52	10972	8	45.07	0.07

年份	双重感染例数	接受抗结核和(或)抗病毒治疗患者例数	单纯抗结核治疗例数	单纯抗病毒治疗例数	同时开展抗结核和抗病毒治疗例数	联合治疗率 (%)
2015	102	95	11	4	80	78.43
2016	126	119	15	10	94	74.60
2017	131	122	8	5	109	83.20
2018	120	118	12	10	96	80.00
2019	106	105	6	3	96	90.57
2020	109	108	1	7	100	91.74
2021	79	77	2	4	71	89.87