丙型病毒性肝炎患者中艾滋病毒相关耐药结核病治疗效果不佳的预测因素

A. V. Kukurika
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引用次数: 0

摘要

研究目的--确定合并耐多药结核病(MDR-TB)、艾滋病病毒感染和丙型病毒性肝炎(HCV)等疾病的患者不良预后的预测因素,以优化护理。本研究共纳入了 132 名 MDRTB/HIV/HCV 三重感染患者:112名患者的治疗效果良好,20名患者的治疗效果不佳。为评估不利结局的预测因素,计算了几率比和 95% 的置信区间。计算出了 95% 的置信区间,并利用逻辑回归建立了预后模型。肺结核泛化过程增加了不利结局的几率,增加了 8.13 倍(95% CI:2.252 - 29.354;P<0.001);使用未纳入新型高效抗结核药物的化疗方案治疗--5.333 倍(95% CI:0.059 - 0.597;P=0.002);药物不良反应--4.263次(95% CI:0.938~19.370;P=0.044);严重药物不良反应--6.429次(95% CI:1.889~21.878;P=0.001);CD4-淋巴细胞计数水平低于50个细胞/μL--7次(95% CI:2.180~22.482;P<0.001);4B期HIV感染--4.1次(95% CI:1.527~11.007;P=0.003).结论。研究结果表明,有必要进一步研究艾滋病毒相关 MDR-TB 合并 HCV 的问题,以便在考虑到已确定的不利治疗结果预测因素的情况下,为这类患者的管理制定循证算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of unfavourable treatment outcomes for HIV-associated MDR-TB in patients with viral hepatitis C
The aim of study – to identify predictors of unfavorable outcomes in patients with co-morbidities of multidrug-resistant tuberculosis (MDR-TB); HIV infection; and viral hepatitis C (HCV) to optimize care.Materials and Methods. A total of 132 patients with MDRTB/HIV/HCV triple infection were included in the study: 112 individuals with favorable outcomes and 20 patients with unfavorable outcomes. To assess predictors of unfavorable outcomes; odds ratios and 95% confidence intervals were calculated. 95% confidence interval were calculated; and a prognostic model was built using logistic regression.Results. Generalization tuberculosis process increased the chance of unfavorable outcome by 8.13 times (95% CI: 2.252 – 29.354; p<0.001); treatment with chemotherapy regimens without the inclusion of the new highly effective antituberculosis drugs – 5.333 times (95% CI: 0.059 – 0.597; p=0.002); undesirable adverse drug reactions – 4.263 times (95% CI: 0.938 to 19.370; p=0.044); severe adverse drug reactions – 6.429 times (95% CI: 1.889 – 21.878; p=0.001); level of CD4-lymphocyte count less than 50 cells/µL – 7 times (95% CI: 2.180 – 22.482; p<0.001); stage 4B HIV infection – 4.1 times (95% CI: 1.527 – 11.007; p=0.003).Conclusion. The results obtained indicate the need to further study the problem of HIV-associated MDR-TB in combination with HCV in order to develop evidence-based algorithms for the management of this category of patients; taking into account the identified predictors of unfavorable treatment outcomes.
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