Armaghane Danesh
ارمغان دانش
armaghanj
Medical Sciences
http://armaghanj.yums.ac.ir
1
admin
1728-6506
1728-6514
10.61186/armaghanj
en
jalali
1402
1
1
gregorian
2023
4
1
28
2
online
1
fulltext
fa
شیوع مایکوباکتریوم توبرکلوزیس در بیماران
مبتلا به HIV به روشهای میکروسکوپی و مولکولی
Investigating the Prevalence of Mycobacterium Tuberculosis in Patientsinfected with HIV Microscopically and Molecularly
میکروبیولوژی
Microbiology
پژوهشي
Research
<span style="font-size:14pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut">زمینه و هدف: </span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut">یکی از چالشهای جهانی در خصوص مبتلایان به </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut">، افزایش حساسیت به پاتوژنهای درون سلولی نظیر سل میباشد. سلولهای</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">CD4+</span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"> عنصر دفاعی اصلی در برابر مایکوباکتریوم توبرکلوزیس هستند، اما در این افراد با کاهش تعداد آنها، خطر ابتلا به توبرکلوزیس افزایش مییابد، حتی درمانهای ضدرتروویروسی گاهی سبب بروز تظاهرات ناشناختهای از بیماری سل میگردد. لذا هدف از این مطالعه تعیین شیوع مایکوباکتریوم </span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut">توبرکلوزیس</span></span> <span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">در بیماران مبتلا به </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> به روش</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif""></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">های میکروسکوپی و مولکولی بود. </span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">روش بررسی</span></span></b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">: این یک مطالعه توصیفی میباشد که بر روی 100 پرونده بیمار مبتلا به </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> که بیش از 6 ماه از درمان ضدرتروویروسی آن ها گذاشته باشد، با ثبت مشخصات دموگرافیک آنها صورت گرفت. ابتدا سه نمونه خلط در زمانهای معین از بیماران</span></span><span lang="FA" style="font-family:Yagut"> نمونهگیری با رعایت اصول استاندارد آزمیشگاهی و ایمنیزیستی در فضای باز انجام شد</span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> که با روش ذیل نلسون رنگ آمیزی و بررسی میکروسکوپی شدند. سپس نمونه خون آنها جهت سنجش </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">CD4+</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> و تعیین بار ویروسی به ترتیب با سل کانتر و</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">Real-Time PCR</span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"> آنالیزشد. دادههای جمعآوری شده با استفاده از آزمونهای آماری </span></span><span lang="FA" style="font-family:Yagut">آنالیز واریانس، همگنی واریانس(لون) و تعقیبی </span><span dir="LTR" style="font-size:8.0pt"><span style="background:white"><span style="font-family:"Arial","sans-serif"">LSD</span></span></span> <span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">تجزیه و تحلیل شدند.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"></span></span></b></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">یافتهها</span></span></b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">: میانگین شمارش </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">CD4+</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> و بار ویروسی در این جامعه به ترتیب 8/722 و 5/177 تعیین گردید. تنها دو درصد جامعه( هر دو نفر زن) دچار عفونت همزمان </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV/TB</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> بودند. بین ابتلا به عفونت و متغییرهای سن، جنسیت، وضعیت تأهل و تحصیلات رابطه معنیداری مشاهده نشد (1/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">(p></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">. بین متغییرهای طول درمان و تعداد +</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">CD4</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> رابطه معنیدار مستقیم(05/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">(p<</span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"> و بین آنها با بار ویروسی رابطه معنیدار معکوس وجود داشت(01/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">(p<</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">نتیجهگیری</span></span></b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut">: شیوع همزمان </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV/TB</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> خوشبختانه محدود به 2 درصد این جامعه بود. البته این افراد صرفا </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> مثبت بودند و خطر عفونت همزمان در مرحله ایدز قطعاً افزایش مییابد. با توجه به نبود واکسن برای</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV</span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"> و بروز عفونتهای باز پدید و نوپدید سل، طراحی استراتژیهایی برای مقابله با عفونت همزمان </span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">HIV-TB</span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"> ضروری است</span></span><span dir="LTR" style="font-size:8.0pt"><span style="font-family:"Arial","sans-serif"">.</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><b><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"></span></span></b></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri","sans-serif""><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"> </span></span></span></span></span></span></span><br>
<span style="font-size:14pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="font-size:9.0pt"><span style="font-family:Yagut"></span></span></span></span></span></span>
<span style="font-size:14pt"><span style="line-height:115%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif"">Background & aim: </span></span></span></b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif"">One of the global challenges regarding HIV patients is the increased sensitivity to intracellular pathogens such as tuberculosis. CD4+ cells are the main defense element against Mycobacterium tuberculosis, but in these people, as their number decreases, the risk of tuberculosis increases, even antiretroviral treatments sometimes cause unknown manifestations of tuberculosis. Therefore, the aim of the present study was to determine the prevalence of Mycobacterium tuberculosis in patients with HIV by microscopic and molecular methods.</span></span></span><span style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><b><span style="font-size:5.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif""></span></span></span></b></span></span></span></pre>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="font-family:"Courier New""><b><span style="font-family:"Arial","sans-serif"">Methods</span></b><span style="font-family:"Arial","sans-serif"">: </span><span lang="EN" style="font-family:"Arial","sans-serif"">The present descriptive study was conducted on 100 cases of HIV-infected patients who had completed more than 6 months of antiretroviral treatment, by recording their demographic characteristics. First, three sputum samples were taken from the patients at certain times in accordance with the standard principles of laboratory and immunobiology in the open air, and they were stained by the following Nelson method and examined microscopically. Then, their blood samples were analyzed with cell counter and Real-Time PCR to measure CD4+ and determine the viral load, respectively. </span><span lang="EN" style="font-family:"Arial","sans-serif"">The collected data were analyzed using ANOVA, homogeneity of variance (LON) and LSD post hoc statistical tests.</span><span style="font-family:"Arial","sans-serif""></span></span></span></pre>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><span style="font-family:"Arial","sans-serif""></span></span></span></span></pre>
<span style="font-size:14pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span dir="LTR" style="font-size:5.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span></span>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><b><span style="font-family:"Arial","sans-serif"">Results</span></b><span style="font-family:"Arial","sans-serif"">:</span> <span lang="EN" style="font-family:"Arial","sans-serif"">The average CD4+ count and viral load in this community were determined as 722/8 and 177/5 respectively. Only two percent of the population (both women) had simultaneous HIV/TB infection. There was no significant relationship between infection and the variables of age, gender, marital status and education (p>0.1). There was a direct significant relationship between the variables of treatment length and CD4+ count (p<0/05) and between them with viral load. There was an inverse significant relationship (p<0/01).</span><span style="font-family:"Arial","sans-serif""></span></span></span></span></pre>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><span style="font-size:5.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></pre>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><b><span style="font-family:"Arial","sans-serif"">Conclusion</span></b><span style="font-family:"Arial","sans-serif"">: </span><span style="font-family:"Arial","sans-serif"">Tuberculosis is the most common opportunistic infection in HIV infected patients. With the lack of a vaccine for HIV and the lack of an effective vaccine for TB, it is necessary to design strategies to deal with HIV-TB co-infection.</span></span></span></span></pre>
<pre style="text-align:justify">
<span style="font-size:10pt"><span style="line-height:115%"><span style="font-family:"Courier New""><b><span style="font-size:6.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif""></span></span></span></b></span></span></span></pre>
<pre style="text-align:justify">
</pre>
AIDS / HIV,عفونت سل, عفونت همزمان
AIDS / HIV, Tuberculosis infection, Co-infection
260
274
http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-2710-1&slc_lang=fa&sid=1
A
Kasavandi
آرزو
کساوندی
arezoo.kasa@gmail.com
100319475328460027194
100319475328460027194
No
Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran,
گروه میکروبیولوژی، واحد شهرقدس، دانشگاه آزاد اسلامی، تهران، ایران
F
Foroohi
فاطمه
فروهی
f_foroohi@ymail.com
100319475328460027195
100319475328460027195
Yes
Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran,
گروه میکروبیولوژی، واحد شهرقدس، دانشگاه آزاد اسلامی، تهران، ایران
T
Rahimi
تورج
رحیمی
Rahimitouraj@gmail.com
100319475328460027196
100319475328460027196
No
Department of Genetics and Plant Production, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
گروه مهندسی ژنتیک و تولید گیاهی، واحد شهرقدس، دانشگاه آزاد اسلامی، تهران، ایران
A
Ferdousi
آتوسا
فردوسی
Dr.at.ferdousi@gmail.com
100319475328460027197
100319475328460027197
No
Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran,
گروه میکروبیولوژی، واحد شهرقدس، دانشگاه آزاد اسلامی، تهران، ایران
T
Mohammadian
طاهر
محمدیان
tmohammadian@gmail.com
100319475328460027198
100319475328460027198
No
Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran,
گروه میکروبیولوژی، واحد شهرقدس، دانشگاه آزاد اسلامی، تهران، ایران