Characteristics and treatment outcomes of co-infected tuberculosis patients with human immunodeficiency virus in Southeast China, 2012-2021.

BACKGROUND: Tuberculosis (TB) is a chronic respiratory infection. Co-infection with human immunodeficiency virus (HIV) has been a significant obstacle to TB control. Insufficient attention has been given to TB/HIV, and more information is needed to address this issue. We conducted an observational study to investigate the epidemiological characteristics, treatment outcomes and its associated factors of HIV-positive TB patients in Southeast China. METHODS: An observational study was conducted based on data collected directly from China National TB Surveillance System during 2012-2021. Epidemiological characteristics, drug resistance and outcomes were described as frequency (n) and percentage (%). Risk factors for unsuccessful outcomes were determined using univariate (chi-squared) and multivariate logistic regression analysis. RESULTS: A total of 347 TB/HIV cases were included, and the proportion of HIV-positive cases among all TB cases increased significantly from 0.06% to 2012 to 0.40% in 2021. The majority of cases were males (86.5%), non-local household registers (139, 40.1%), farmers or workers (179, 51.6%), and aged 40-59 (142, 40.9%). Of 347 cases, 290 (83.6%) had pulmonary TB (PTB), 10 (2.9%) had extra pulmonary TB (EPTB) and 47(13.5%) had both PTB and EPTB. A total A total of 258 (74.4%) were HIV positive prior to TB diagnosis. 8.0% (4/50) of cases were resistant to rifampicin (RIF) and 274 patients (83.8%) had successful outcomes. Being non-local (AOR = 2.193, 95% CI = 1.196-4.022, P = 0.011) and diagnosed HIV infection after TB (AOR = 2.365, 95% CI = 1.263-4.430, P = 0.007) were independent risk factors for unsuccessful outcomes of anti-TB treatment. CONCLUSION: During 2012-2021, the proportion of HIV-positive cases among all TB cases increased significantly in Southeast China. HIV-positive TB patients were significantly more likely to develop resistance to RIF and INH and unsuccessful anti-TB treatment. Non-local registration and becoming HIV positive after TB diagnosis were independent risk factors associated with unsuccessful outcomes.

[Genetic polymorphism of the gene encoding the apical membrane antigen-1 of Plasmodium falciparum].

OBJECTIVE: To study the genetic diversity of apical membrane antigen-1 gene from Plasmodium falciparum (PfAMA-1). METHODS: Filter paper blood samples were collected from 23 imported P. falciparum malaria patients who returned to Fujian Province from 2006 to 2012. Nested PCR were used to amplify the PfAMA-1 gene. The umplified fragments were sequenced, and analyzed by bioinformatic software. RESULTS: All 23 samples were amplified a 505 bp band. Thirty-two nucleotides were found to be variable, resulting in 18 haplotypes. Eight of these 18 halotypes were being reported here for the first time. The parasites collected from Africa showed the higher level of variability [haplotypes diversity (Hd)= 0.0985, nucleotide diversity (π)=0.0258] as compared to the isolates from Asia (Hd=0.909, π=0.0221). The average difference of dN-dS for all 23 PfAMA-1 sequences was 0.031±0.006. Sequence-based neutrality tests were not significant in Africa and Asia (P>0.05). The minimum number of recombination events (Rm) was 10, and the linkage disequilibrium index (R2) evidently declined with the increase of nucleotide distance. A molecular phylogenetic tree constructed using the neighbor-joining method showed that the 23 isolates were assigned to three clades (G1, G2 and G3). Most samples from Africa formed G1, and G3 contained most of Asian isolates. CONCLUSION: Plasmodium falciparum isolates from Africa show a higher genetic diversity than the isolates from Asia for PfAMA-1 gene.