Changes in the epidemiology and clinical manifestations of human immunodeficiency virus-associated tuberculosis in Hong Kong.

IF 3.1 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Hong Kong Medical Journal Pub Date : 2024-08-01 Epub Date: 2024-07-16 DOI:10.12809/hkmj2310683
A C K Chan, S S Huang, K H Wong, C C Leung, M P Lee, T Y Tsang, W S Law, L B Tai
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Abstract

Introduction: Human immunodeficiency virus (HIV)-associated tuberculosis (TB) remains an important health challenge worldwide. Although TB prevalence has decreased in the general population, there is limited information regarding temporal trends in the incidence of HIV-associated TB in Hong Kong. There are also insufficient data regarding changes in clinical manifestation patterns among HIV-associated TB patients over time. This study aimed to describe temporal trends in the epidemiology and clinical manifestations of HIV-associated TB in Hong Kong.

Methods: We retrospectively reviewed data regarding HIV-associated TB patients that were reported to the TB-HIV Registry of the Department of Health during the period 2007 to 2020. Trends of TB as a primary acquired immunodeficiency syndrome (AIDS)-defining illness, as well as changes in demographic features and clinical manifestations of HIV-associated TB during this period were examined using Cochran-Armitage trend test.

Results: A decreasing trend was observed in the proportion of all reported cases of AIDS in which TB was a primary AIDS-defining illness during the study period. The proportions of female patients and patients with extrapulmonary involvement significantly increased, whereas the proportions of ever-smokers and patients with sputum smear positivity significantly decreased during the same period. A decreasing trend was observed in the proportion of patients with pulmonary TB in which the lower zone was the predominant site of lung parenchymal lesions. Among patients with a diagnosis of HIV infection before TB, an increasing trend was observed in the proportion of patients receiving antiretroviral therapy.

Conclusion: Important temporal changes were observed in the epidemiology and clinical manifestations of HIV-associated TB. These results highlight the need for continued surveillance regarding the patterns of demographic features and clinical manifestations to inform policymakers when planning control strategies for HIV-associated TB.

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香港与人体免疫缺陷病毒有关的结核病的流行病学和临床表现的变化。
导言:与人类免疫缺陷病毒(HIV)相关的结核病(TB)仍然是全球面临的一项重要健康挑战。虽然结核病在一般人群中的发病率有所下降,但有关香港艾滋病毒相关结核病发病率的时间趋势的资料却很有限。有关艾滋病病毒相关肺结核患者临床表现模式随时间变化的数据也不足。本研究旨在描述香港艾滋病病毒相关结核病的流行病学和临床表现的时间趋势:我们回顾了 2007 年至 2020 年期间向卫生署结核病-艾滋病毒登记处报告的与艾滋病毒相关的结核病患者的数据。我们使用 Cochran-Armitage 趋势检验法研究了在此期间肺结核作为获得性免疫缺陷综合征(艾滋病)原发病的趋势,以及艾滋病病毒相关肺结核的人口学特征和临床表现的变化:结果:在研究期间,在所有报告的艾滋病病例中,结核病是艾滋病定义的主要疾病的比例呈下降趋势。同期,女性患者和肺外受累患者的比例明显上升,而曾经吸烟者和痰涂片阳性患者的比例则明显下降。在肺结核患者中,下肺区是肺实质病变的主要部位,这一比例呈下降趋势。在肺结核前已确诊感染艾滋病毒的患者中,接受抗逆转录病毒治疗的患者比例呈上升趋势:结论:在艾滋病相关肺结核的流行病学和临床表现方面观察到了重要的时间变化。这些结果突出表明,有必要对人口特征和临床表现的模式进行持续监测,以便决策者在规划艾滋病毒相关结核病的控制策略时掌握相关信息。
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来源期刊
Hong Kong Medical Journal
Hong Kong Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
1.50
自引率
14.80%
发文量
117
审稿时长
10 weeks
期刊介绍: The HKMJ is a Hong Kong-based, peer-reviewed, general medical journal which is circulated to 6000 readers, including all members of the HKMA and Fellows of the HKAM. The HKMJ publishes original research papers, review articles, medical practice papers, case reports, editorials, commentaries, book reviews, and letters to the Editor. Topics of interest include all subjects that relate to clinical practice and research in all branches of medicine. The HKMJ welcomes manuscripts from authors, but usually solicits reviews. Proposals for review papers can be sent to the Managing Editor directly. Please refer to the contact information of the Editorial Office.
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