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Active tuberculosis and Mycobacterium tuberculosis latent infection in patients with HIV/AIDS

机译：HIV / AIDS患者的活动性结核和结核分枝杆菌潜伏感染

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Objectives Tuberculosis (TB) remains an important disease associated with HIV infection and AIDS in Brazil, even in a setting of free access to antiretroviral therapy (ART) and TB treatment. In previous studies, isoniazid therapy (IT) for latent infection with Mycobacterium tuberculosis (LIMTb) was found to reduce the risk of TB by 62% in patients with a tuberculin test (TT)> 5 mm. The objectives of this study were to investigate the occurrence of TB, the prevalence of LIMTb and the coverage of the TT and IT, and to estimate the number of missed opportunities to prevent TB in patients with HIV/AIDS. Methods A random sample of patients with HIV/AIDS was selected; data from the medical files were obtained, and a TT was performed in consenting subjects. Results In the 203 subjects included in the study, TB occurrence was 13.3%, LIMTb prevalence was 20% and the coverage of the TT and IT was 59.2 and 55%, respectively. Patients with TB had a lower nadir CD4 cell count, but their CD4 recovery was comparable to that of non-TB patients. Patients with LIMTb always had a higher CD4 cell count. Conclusions By expanding the coverage of the TT and IT to nearly 100%, we could more than double the number of prevented cases of TB. TB prevention programmes must be reinforced to reduce the number of missed opportunities for diagnosis, and IT must be improved to reduce TB among patients with HIV/AIDS. Empowering patients with knowledge about TB, the preventive role of IT and the need for an annual TT may be the best way of lowing rates of TB in patients with HIV/AIDS.
机译：目的即使在免费获得抗逆转录病毒疗法（ART）和结核病治疗的环境中，结核病（TB）仍然是巴西与HIV感染和艾滋病相关的重要疾病。在先前的研究中，发现结核菌素试验（TT）> 5 mm的患者中，异烟肼疗法（IT）用于结核分枝杆菌（LIMTb）的潜伏感染可将结核病风险降低62％。这项研究的目的是调查结核病的发生，LIMTb的患病率以及TT和IT的覆盖率，并估计艾滋病毒/艾滋病患者错过预防结核病机会的数量。方法随机抽取艾滋病毒/艾滋病患者。从医疗档案中获取数据，并在同意的受试者中进行TT。结果纳入研究的203名受试者中，TB发生率为13.3％，LIMTb患病率为20％，TT和IT的覆盖率分别为59.2和55％。结核病患者的最低CD4细胞计数较低，但其CD4回收率与非结核病患者相当。 LIMTb患者始终具有较高的CD4细胞计数。结论通过将TT和IT的覆盖率扩大到近100％，我们可以将结核病预防病例的数量增加一倍以上。必须加强结核病预防计划，以减少错过的诊断机会，必须改进信息技术以减少艾滋病毒/艾滋病患者的结核病。使患者具有结核病知识，IT的预防作用以及每年进行TT的需求，可能是降低HIV / AIDS患者结核病发生率的最佳方法。

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