title: High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China.
abstract: Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang.
  
  
  
  In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis.
  
  
  
  The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001).
  
  
  
  The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.
authors.affiliation: Department of Prevention and Health Care, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Rena
authors.initials: R
authors.lastname: Maimaiti
authors.affiliation: Department of Infection Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infection Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Kejun
authors.initials: K
authors.lastname: Pan
authors.affiliation: Department of Epidemiology and Biostatistics, Xinjiang Medical University, Urumqi, China.
authors.forename: Peierdun
authors.initials: P
authors.lastname: Mijiti
authors.affiliation: Department of Infection Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Maimaitiali
authors.initials: M
authors.lastname: Wubili
authors.affiliation: The Clinic of Liudaowan Hospital of Urumqi, Urumqi, Xinjiang, China.
authors.forename: Maimaitijiang
authors.initials: M
authors.lastname: Musa
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden. rune.andersson@gu.se.
authors.forename: Rune
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000328:Adult; D018890:Chemoprevention; D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000188:drug therapy* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012074:Remission Induction; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D007538:Isoniazid
keywords: HIV; Isoniazid prophylaxis; Treatment outcome; Tuberculosis