10.3969/j.issn.1007-3969.2013.04.005

Objective To understand the effect of antiretroviral therapy (ART) in reducing deaths among patients co-infected with Mycobacterium tuberculosis and human immunodeficiency virus (TB/HIV),and provide data-based evidence for improving ART in TB/HIV patients.Methods The information about TB patients who were HIV positive confirmed previously or recently in Guangxi were collected,and the TB/HIV patients were confirmed by using the related data from national AIDS prevention and treatment information system.Then a retrospective case control study was conducted to understand the survivals and deaths in the patients receiving ART or receiving no ART by using Kaplan-Meier method and estimate the ART protective rate within 1 year after TB treatment initiation.Results Among 519 TB/HIV patients,100 received ART (19.3％) ; Among 84 TB/HIV patients who died within 1 year after TB treatment,8 (9.5％) received ART,while 76 (90.5％) received no ART.Compared with the 18.7％ mortality rate in non-ART group,TB/HIV patients mortality rate in ART group was only 8.08％,the difference was statistical significant (P＜0.05).Kaplan-Meier survival curve showed that the survival rate in patients receiving ART was higher than that in patients receiving no ART within 1 year after TB treatment,the difference was statistical significant (Log-rank=4.96,P=0.02).Compared with patients receiving ART,the OR value was 2.31 times higher than that in patients receiving no ART; ART could protect 56.7％ of TB/HIV patients against death during the first year of anti-TB therapy.Conclusion In the first year of anti-TB therapy,the risk of death in TB/HIV patients receiving no ART was much higher than that in TB/HIV patients receiving ART,and the survival time was longer in the patients receiving ART.The ART coverage should be expanded in TB/HIV patients.