Association of HIV infection with extrapulmonary tuberculosis: a systematic review.
Association of HIV infection with extrapulmonary tuberculosis: a systematic review.
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DOI：
10.1007/s15010-016-0960-5
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发表时间：
2017-02
期刊：
影响因子：
7.5
通讯作者：
Pham K
中科院分区：
文献类型：
--
作者：
Shivakoti R;Sharma D;Mamoon G;Pham K
艾滋病毒/艾滋病是肺结核(PTB)发展的已知危险因素。然而，艾滋病毒和肺外结核病(EPTB)之间的联系不太清楚。我们进行了一项系统的回顾，以确定HIV和EPTB之间的联系。我们检索了电子数据库Medline、Embase和相关会议文献，使用定义的EPTB和HIV搜索词。我们的搜索标准不包括研究参与者的年龄或地理位置的限制，只包括英文出版物和报告调整后估计的研究。进行定性和定量分析(包括异质性的I2检验)。从1984-2016年间进行的16项研究(15项横断面研究和1项病例对照研究)在筛选了5163篇文章和会议摘要后进入最终分析。我们的定性分析表明，研究设计和研究人群特征的异质性，以及大多数研究中的中等/高度偏向风险。虽然大多数单独研究表明，在HIV感染者中，与结核病相比，EPTB的几率更高，但我们没有提供总体综合估计，因为横断面研究的I2值高达93%。虽然在大多数个体研究中观察到HIV和EPTB之间的联系，但这些研究中的高度异质性和偏见风险突显了进一步设计良好的前瞻性队列研究的必要性，以评估HIV感染患者群体中EPTB的真实风险。
HIV/AIDS is a known risk factor for the development of pulmonary tuberculosis (PTB). However, the association is less clear between HIV and extrapulmonary tuberculosis (EPTB). We conducted a systematic review to determine the association between HIV and EPTB. We searched the electronic databases Medline, Embase and relevant conference literature using defined search terms for EPTB and HIV. Only publications in English and only studies reporting adjusted estimates were included while our search criteria did not include restriction by age or geographic location of study participants. Qualitative and quantitative analyses (including I2 test for heterogeneity) were performed. 16 studies (15 cross-sectional and 1 case-control) conducted from 1984-2016 were included in the final analyses after screening 5163 articles and conference abstracts. Our qualitative analysis showed heterogeneity in study design and study population characteristics along with a medium/high risk of bias in the majority of studies. While most of the individual studies showed increased odds of EPTB compared with PTB among HIV-infected individuals, we did not provide an overall pooled estimate, as the I2 value was high at 93% for the cross-sectional studies. While an association between HIV and EPTB is observed in most individual studies, the high heterogeneity and risk of bias in these studies highlight the need for further well-designed prospective cohort studies to assess the true risk of EPTB in the HIV infected patient population.