JIANGYAN TENG, HOUCUI FAN, TAO ZHANG
Linyi People’s Hospital, Linyi 276034, China
Objective: This paper analyzes the specific factors that lead to death in the course of anti-tuberculosis treatment of patients with double infections of mycobacterium tuberculosis and HIV, consequently providing guidance for future clinical treatment.
Methods: The 276 patients with mycobacterium tuberculosis and HIV treated in our hospital from March 2014 to December 2016 were enrolled in this study. A prospective & retrospective analysis was conducted to estimate probability of death during the course of treatment and summarizes the factors leading to death.
Results: During the treatment period, 29 patients died, with odds of 10.51%. Statistical analysis showed that mortality was significantly lower in patients receiving antiviral therapy than those who did not (P <0.05). In addition, the probability of death occurrence could be reduced with early antiviral therapy. Based on HIV infection route, it could be noted that the mortality of intra- venous drug users was significantly higher than patients with sexually transmitted infections (P <0.05). This could be observed from infection type of mycobacterium tuberculosis, whereby mortality of patients with smear positive pulmonary tuberculosis infection was substantially higher than those with smear negative pulmonary tuberculosis and patients with extrapulmonary tuberculosis alone (P <0.05). Meanwhile the mortality of patients with CD4 + T lymphocyte level> 350 cells/μl was significantly higher than patients with other cases (P <0.05).
Conclusion: HIV infection route, severity of tuberculosis, antiviral therapy and early treatment are the significant relevant factors that affect the death of patients infected with mycobacterium tuberculosis and HIV in the course of anti-tuberculosis treatment. These factors demand severe attention besides symptomatic treatment should be comprehended in all clinical institution to ensure patients’ wellbeing.
Tuberculosis infection, HIV, dual infection, fatal cause