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[目的]了解河南地区结核(TB)病人群中艾滋病病毒(HIV)感染情况,为制订TB/HIV双重感染防治工作规划提供依据。[方法]采取WHO推荐的在结核病人中监测HIV感染的方案,采用整群分层抽样方法,以第五轮全球基金结核病项目县13个单位和根据2006年各县报告HIV感染情况另外抽取低疫情地区12个非项目县为调查点,对调查期内新登记的结核病人采用关联保密的方法,用酶联免吸附试验(ELISA)进行HIV初筛,初筛阳性者做免疫印迹(WB)确认试验,并进行问卷调查。[结果]新登记结核病人HIV受检率97.6%,HIV阳性率2.08%;结核病合并HIV感染者30～59岁组占86.2%;结核病合并HIV感染者中肺外结核占8.05%,痰涂片阳性占46%,CD4低于200个/MM3者占64.8%;、第五轮全球基金结核病项目地区结核病人中HIV阳性率、已知HIV阳性人数、转诊率、推荐率(2.89%、66、3.15%、5%)明显高于非项目地区(0.49%、3、0.9%、0);结核病合并HIV感染者中因血液传播占74.7%,因异性传播占8%。[结论]第五轮全球基金结核病项目地区结核病人中HIV感染处于中等流行水平,非项目地区结核病人中HIV感染处于低流行水平;HIV感染者中肺外结核、涂阴肺结核存在漏诊问题,应加强对双感染病人的诊断技术培训。
[Objective] To understand the status of HIV infection in tuberculosis (TB) patients in Henan Province and provide the basis for the preparation of TB / HIV dual infection prevention and control work plan. [Methods] A WHO-recommended protocol for monitoring HIV infection among tuberculosis patients was adopted. A cluster stratified sampling method was used to extract 13 additional units from the fifth round of the Global Fund-funded TB project counties and to report HIV infection according to the 2006 counties Twelve non-project counties in the epidemic outbreak were used as investigation points. Newly registered TB patients in the investigation period were screened for HIV by ELISA and ELISA. Western blotting (WB) Confirm the test and conduct a survey. [Results] The HIV positive rate of newly registered TB patients was 97.6% and the HIV positive rate was 2.08%. TB patients with HIV infection accounted for 86.2% of patients aged 30-59 years. Among tuberculosis patients with HIV infection, extrapulmonary tuberculosis accounted for 8.05% and sputum smear Positive 46%, CD4 less than 200 / MM3 accounted for 64.8%; the fifth round of Global Fund TB cases in areas of TB HIV positive rate, known HIV-positive number, referral rate, the recommended rate (2.89%, 66 , 3.15%, 5%) were significantly higher than those in non-project areas (0.49%, 3,0.9%, 0). Tuberculosis patients with HIV infection accounted for 74.7% due to blood transmission and 8% due to heterosexual transmission. [Conclusion] The prevalence of HIV infection among TB patients in the fifth round of Global Fund TB projects is at a moderate level, and the HIV prevalence of tuberculosis patients in non-project areas is at a low prevalence level. Misdiagnosis of extrapulmonary tuberculosis and smegma-negative pulmonary tuberculosis in HIV-infected patients should be Strengthen the diagnosis of double infectious patients training.