Study on Immune Function and Drug Resistance of Tuberculosis Patients Co-infected with HBV,HCV and HIV in Yunnan / 昆明医科大学学报

ABSTRACT

Objective To explore the co-infection rate,immune function and drug resistance status among tuberculosis patients co-infected with HBV,HCV and HIV in Yunnan.Methods A total of 2271 TB patients in Yunnan province admitted to the Third People's Hospital of Kunming from April 2020 to March 2023 were collected for HBV,HCV,HIV serological tests,lymphocyte tests and drug resistance gene detection,and analysis of TB infection of HBV,HCV,HIV infection,immune function and resistance.Results Among the 2271 TB patients,499 cases were infected with TB and HBV,the infection rate was 21.97%.196 cases were infected with HCV,the infection rate was 8.63%.166 cases were infected with HIV,the infection rate was 7.31%.There were 1410 patients with simple tuberculosis,accounting for 62.09%.The infection rates of tuberculosis combined with HBV,HCV and HIV were statistically significant in different age groups(P<0.01).The absolute number expression of CD3+,CD4+ and CD8+T cells was higher in TB patients with HBV and HCV,and the differences between the two were statistically significant(P<0.05).The absolute number expression of CD3+ and CD4+T cells was lower in TB patients with HIV,and the absolute number expression of CD8+T cells was increased,and the difference between the two was statistically significant(P<0.01).The absolute number of CD3+,CD4+ and CD8+T cells was higher in female patients with tuberculosis and HIV,and the differences were statistically significant(P<0.05).In all age groups,the absolute number of CD3+ and CD8+T cells in tuberculosis patients with HIV was the lowest in 46-65 years old group,and the differences were statistically significant(P<0.05).Among the 2271 TB patients,391 were resistant to any first-line drug(single drug resistance),and the overall drug resistance rate was 17.22%.Among them,52 cases were combined with HBV drug resistance,the resistance rate was 10.42%.There were 10 cases with HCV drug resistance,the drug resistance rate was 5.10%.40 cases were combined with HIV drug resistance,the drug resistance rate was 24.10%.Drug resistance in 289 patients with simple tuberculosis was 20.50%.Among them,33 cases were single drug resistant rifampicin,accounting for 19.88%.Conclusion Tuberculosis has the highest rate of co-infection with HBV,and the immune function of TB patients co-infected with HIV is the worst.The drug resistance rate of TB patients co-infected with HIV is also the highest,with resistance to rifampicin being the most common.TB is a chronic wasting disease,with poorer immune function compared to the general population,making it more susceptible to HBV infection.TB patients who are also infected with HIV tend to have worsened immune function and increased drug resistance.