Impact of Integrating HIV and TB Care and Treatment in a Regional Tuberculosis Hospital in Rural Guatemala
Impact of Integrating HIV and TB Care and Treatment in a Regional Tuberculosis Hospital in Rural Guatemala
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DOI：
10.1007/s10461-013-0595-9
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发表时间：
2014-01-01
影响因子：
4.4
通讯作者：
Hearst, Norman
中科院分区：
文献类型：
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作者：
Ikeda, Janet Midori;Tellez, Cesar A. Lopez;Hearst, Norman
资源有限的环境在合并感染患者的结核病和艾滋病毒综合护理方面进展缓慢。我们研究了结核病/艾滋病综合治疗对危地马拉西部农村地区临床和生存结果的影响。来自254名新诊断的结核病/艾滋病患者（2005年8月至2006年7月99名参加了预整合方案，2008年2月至2009年1月155名参加了整合方案）的前瞻性数据显示，两个时期的客户之间没有显著的基线差异。他们主要是男性（65.5%），玛雅人（71%），中位年龄33岁，CD 4计数平均为111个细胞/mm（3）。TB/HIV合并感染患者在综合方案中比在综合方案前更有可能接受抗逆转录病毒治疗（分别为72%和22%），死亡率较低（HR 0.22，95% CI 0.14-0.33）。这项研究表明，如何使用结核病环境作为结核病/艾滋病毒综合护理的切入点，可以改善危地马拉农村艾滋病毒阳性患者的健康结果。
Resource-limited settings have made slow progress in integrating TB and HIV care for co-infected patients. We examined the impact of integrated TB/HIV care on clinical and survival outcomes in rural western Guatemala. Prospective data from 254 newly diagnosed TB/HIV patients (99 enrolled in the pre-integrated program from August 2005 to July 2006, and 155 enrolled in the integrated program from February 2008 to January 2009) showed no significant baseline differences between clients in the two periods. They were principally male (65.5 %), Mayan (71 %), median age 33 years, and CD4 count averaged 111 cells/mm(3). TB/HIV co-infected patients were more likely to receive antiretroviral therapy in the integrated program than in the pre-integrated program (72 vs. 22 %, respectively) and had lower mortality (HR 0.22, 95 % CI 0.14-0.33). This study shows how using a TB setting as the entry point for integrated TB/HIV care can improve health outcomes for HIV-positive patients in rural Guatemala.