Analysis Of The Clinical Epidemiology And Living Situation Of HIV/Pulmonary Tuberculosis-coinfected Patients

Back ground World Health Organization report shows that by the end of 2015,the total of number of people living with HIV was about 36.7 million,including 34.9 million adults.The total number of people newly infected with HIV was about 2.1 million,including 1.9 million adults.The total number of AIDS deaths was about 1.1 million,including 1.0 million adults.Tuberculosis(more than 90% is pulmonary tuberculosis)is the leading opportunistic infection and cause of mortality among people with human immunodefic iency virus(HIV)infection.The diseases influence each other,accelerates the disease deteriorat ion and spreading.In 2014,an estimated 1.2 million(12%)of the 9.6 million people who developed TB worldwide were HIV-positive.In 2014,HIV-associated TB deaths accounted for 25% of all TB deaths(among HIV-negat ive and HIV-posit ive people)and one third of the estimated 1.2 million deaths from HIV/ AIDS.In China,the number of people living with HIV-posit ive tuberculosis was 13,000,while 700 die from tuberculosis.In order to improve the survival rate of patients with dual infection,we need to understand the clinical epidem iology of patients and their survival status,to explore the factors that affect prognosis,and making effective countermeasure.Objectives 1.By statistical the surviva l situation of HI V/Pulmonary tuberculosis-coinfected patients in the treatment period and several years after the end of the course,to obtain the mortality rate of patients with dual infection.2.To understand the basic situation of HI V/Pulmonary tuberculosis-coinfected patients,and to analyze the Clinical epidemiology.3.To analyze the risk factors for the prognosis of HIV/Pulmonary tuberculosis-coinfected patients,and put forward the intervention measures to reduce the mortality.Contents and Methods According to the pre-designed questionnaire,the data of demographic,clinical diagnosis and treatment,complications and laboratory tests were collected,and by the outpatient follow-up and telephone follow-up,to understand the survey of the current living conditions,survival time and related death informat ion.Data analysis using SPSS Statistics 22.0 software,the normal distribution of measurement data using `x ± s description,non-normal distribution of measurement data using the median(quartile)descriptor,classification data using composition rat io description;multivariat e Logistic regression analysis and survival analysis were performed to determine the factors influencing prognosis.Results 1.The follow-up mortality rate in this study was 15.92%,of which 79.25% died within 6 months.2.The ratio of male to female in this study was 9.56: 1,mainly in the aged 31-45 years,the discovery was delayed of 42.62 percent of patients.3.In this study,HIV/Pulmonary tuberculosis-coinfected patients mainly with cough,sputum,asthenia,anorexia,weight loss,dyspnea,night sweats,etc.Chest CT showed 60.69% of the lesion range of ? 3 visual field,49.56% of the first CD4+T lymphocyte count ? 50/mm3,complications and opportunistic infections are mainly central nervous system infections,pulmonary infection,syphilis,HBV and HCV,drug-induced liver damage and so on.4.In this study,the patients of HI V/Pulmonary tuberculosis-coinfected drug-resistance was severe,45.45% of patients with at least a anti-tuberculosis drug resistance,18.84% of patients were multi-drug resistant.5.Years of age,combined with other pulmonary infection,combined with central nervous system infection and the first CD4+T lymphocyte count group were the factors influencing mortality and time-to-live for patients of HI V/Pulmonary tuberculosis-coinfected.The discovery was delayed was the factor influencing mortality for patients.Patients with atelectasis survival rate is low.6.The risk of death was higher and survival rates was lower for patients whose to start anti-retroviral therapy after 8 weeks of anti-tuberculous therapy.Policy suggestions 1.We should strengthen the publicity about education of the relevant knowledge,so that people can strengthen the understanding and cognition of AIDS.2.Strengthen the management of elder ly pat ients in HI V/Pulmonary tuberculosis-coinfected patients.3.Strengthen the cooperation of AIDS prevention and control institut ions and TB prevention and control inst itutions,establish a effective mult i-sectoral cooperation mechanism,improve the screening rate of HIV in T B pat ients and raise the awareness of HIV status.4.To play a mult idisciplinary advantage in the clinical,collectively control the related diseases.5.Screening the drug resistant situation of patients timely,attention to the HIV/PTB treatment of standardized management.