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目的 调查HIV感染者和艾滋病(AIDS)患者并发潜伏结核感染(latent tuberculosis infection,LTBI)的水平、流行病学特征及影响因素.方法 于2013年9月至2015年8月对广西壮族自治区南宁市、贵港市、来宾市3个研究点的AIDS防治机构的HIV感染者和AIDS患者进行筛选,共纳入860例.调查对象均为当地AIDS防治机构目前可随访到的新登记患者及既往患者,且其感染HIV之后未服用过抗结核药物,其中,南宁市纳入的是AIDS住院患者,贵港市和来宾市纳入的是HIV感染与AIDS患者的门诊随访者.收集调查对象的基本信息和临床资料,选取其中MTB潜伏感染(LTBI)者[无结核相关症状体征、仅有γ-干扰素释放试验(IGRA)阳性]、MTB和HIV双重感染者,以及单纯HⅣ感染者和AIDS患者(排除非结核分枝杆菌感染、MTB和HIV双重感染和LTBI者),应用多分类logistic回归分析HIV感染者和AIDS患者并发LTBI及活动性肺结核的影响因素.结果 860例调查对象中LTBI者1 56例,检出率为18.14％(156/860),其中贵港市(门诊随访患者)、来宾市(门诊随访患者)和南宁市(住院患者)的LTBI检出率分别为30.79％ (97/315)、19.47％ (51/262)和2.83％(8/283),各地区间LTBI检出率差异有统计学意义(x2=78.97,P＜0.01).经多因素分析,相对于LTBI者,商业性行为有时使用安全套者[相对风险比(relative risk ratio,RRR)=7.65,95％ CI=2.61～22.39]或从不使用安全套者(RRR=10.28,95％CI=4.08～25.88),经血液途径传播HIV者(RRR=10.20,95％CI=2.55～40.71)发展为活动性结核病的可能性较大;而门诊来源(RRR=0.01,95％ CI=0.00～0.05)、居住在城市(RRR=0.19,95％ CI=0.06～0.67),估计HIV感染病程在5～10年(RRR=0.17,95％ CI=0.04～0.69)或大于10年(RRR=0.18,95％CI=0.04～0.78)的LTBI者不易发展为活动性结核病.相对于LTBI者,门诊患者(RRR=0.17,95％ CI=0.05～0.64),HIV感染病程大于10年者(RRR=0.29,95％ CI=0.14～0.63),并发其他机会性感染者(RRR=0.18,95％CI=0.08～0.41)是单纯HIV感染者和AIDS患者可能性不大.结论 门诊随访的HIV感染者和AIDS患者LTBI的检出率高于住院患者,作为罹患结核和潜伏感染的高危人群,需要加强对其监控和预防性治疗干预;稳定的身体和生活条件,抗病毒治疗及防病意识可阻止结核病的发生和发展.“,”Objective To explore the epidemiological characteristics and influence factors of latent tuberculo sis infection (LTBI) among HIV/AIDS.Methods A total of 860 HIV/AIDS from Nanning,Guigang and Laibin between September 2013 and August 2015 were selected,all the patients did not accept anti-tuberculosis (anti-TB)treatment before and were well followed up.The participants from Nanning were inpatients and others were outpatients.Basic information and clinical records were collected,data of LTBI patients (Interferon-Gamma Release Assays (IGRA) positive without clinical symptoms),TB/HIV co infection patients and pure HIV/AIDS (exclude LTBI,TB/HIV and nontuberculosis mycobacteria) were analyzed using Multinomial Logistic Regression to detect the influence of TB infection and development among HfV/AIDS.Results LTBI detection rate was 18.14％(156/860);30.78％ (97/315) in Guigang,19.47％ (51/262) in Laibin and 2.83％ (8/283) in Nanning (inpatients),the differences were statistically significant (x2=78.97,P＜0.01).Compared to LTBI patients,TB/HIVco-infection patients were more likely to be someone had low frequency (RRR=7.65,95％CI=2.61-22.39) orrarely (RRR=10.28,95％CI=4.08 25.88) using condom during commercial sexual intercourse and someone hadbeen infected HIV by blood transmission (RRR=10.20,95％CI=2.55-40.71).However,outpatient paitents(RRR=0.01,95％ CI=0.00-0.05) and the ones from urban area resident (RRR=0.19,95 ％ CI=0.06-0.67),who had the duration of HIV infection between 5 to 10 years (RRR=0.17,95％CI=0.04-0.69) or over 10 years(RRR=0.18,95％ CI=0.04-0.78) was unlikely to be TB/HIV co-infection patients.The probability of aHIV/AIDS patient survive from LTBI was less if he or she was outpatient (RRR=0.17,95％CI=0.05 0.64) orhad the duration of HIV infection over 10 years (RRR=0.29,95％ CI=0.14 0.63) or had other opportunisticinfections (RRR=0.18,95％CI=0.08-0.41).Conclusion LTBI detection rate in outpatients was higher thaninpatients,the monitoring and prevention treatment interventions should be strengthened.Stable health and livingconditions,antiretroviral therapy and disease prevention awareness help to inhibit the occurrence and development ofTB.