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. 2017 Jan 5;17(1):15.
doi: 10.1186/s12879-016-2152-4.

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

Rena Maimaiti  1 , Yuexin Zhang  2 , Kejun Pan  2 , Peierdun Mijiti  3 , Maimaitiali Wubili  2 , Maimaitijiang Musa  4 , Rune Andersson  5
Affiliations

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

Rena Maimaiti et al. BMC Infect Dis. .

Abstract

Background: Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang.

Methods: In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis.

Results: The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001).

Conclusions: The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

Keywords: HIV; Isoniazid prophylaxis; Treatment outcome; Tuberculosis.

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Figures

Fig. 1
Fig. 1
Flow chart detailing recruitment and TB presentation
Fig. 2
Fig. 2
Survival time in 333 patients with HIV + tuberculosis and in 2668 with HIV only
Fig. 3
Fig. 3
Survival time in 1247 patients with intravenous drug use (IVDU) compared to 1353 patients with no IVDU. (For 432 patients data were missing)
See this image and copyright information in PMC

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