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卫生部办公厅关于印发《全国结核菌/艾滋病病毒双重感染防治工作实施方案（试行）》的通知
来源：中国政府网 2010年08月03日09:27
卫生部办公厅关于印发《全国结核菌/艾滋病病毒双重感染防治工作实施方案（试行）》的通知
卫办疾控发〔2010〕126号
各省、自治区、直辖市卫生厅局，新疆生产建设兵团卫生局，中国疾病预防控制中心：
结核病是艾滋病病毒感染者和病人常见的机会性感染和主要死亡原因，结核病病人中的艾滋病病毒感染也明显高于普通人群。结核菌/艾滋病病毒双重感染已成为我国结核病防治工作的重要挑战，同时严重影响着艾滋病防治工作的开展。为进一步加强结核病和艾滋病防治工作，有效应对结核菌/艾滋病病毒双重感染问题，我部制定了《 全国结核菌/艾滋病病毒双重感染防治工作实施方案（试行）》。现印发给你们，请参照执行。
全国结核菌/艾滋病病毒双重感染
防治工作实施方案（试行）
结核菌/艾滋病病毒双重感染（以下简称TB/HIV双重感染）是我国结核病和艾滋病防治工作面临的严峻挑战之一，为进一步加强全国TB/HIV双重感染防治工作，特制定以下实施方案。
一、工作目标
建立和完善全国TB/HIV双重感染防治工作机制，以TB/HIV双重感染病人为重点，加大发现、治疗和管理力度，控制结核病和艾滋病的进一步传播，保护公众健康。
二、防治策略
（一）加强医防合作，建立结核病和艾滋病防治机构的合作机制，充分依托TB/HIV双重感染定点治疗机构，共同开展TB/HIV双重感染工作。
（二）为新发现和随访中的艾滋病病毒感染者和病人提供结核病问卷筛查和检查服务。
（三）为艾滋病高、中流行县（区）新登记的结核病病人提供HIV抗体检测服务。
（四）为TB/HIV双重感染病人及时提供相应的治疗和随访管理服务。
三、组织领导和职责分工
（一）组织领导。
由各级卫生行政部门牵头，成立TB/HIV双重感染防治领导小组和技术工作组，结核病防治机构会同艾滋病防治机构具体负责组织协调和联络工作。
领导小组由各级卫生行政部门、疾病预防控制机构和医疗机构等相关领导组成，负责组织、协调本辖区TB/HIV双重感染防治工作，制订年度工作计划，落实防治工作经费，开展监督、评估等工作。
技术工作组由各级结核病防治机构、艾滋病防治机构和TB/HIV双重感染定点治疗机构等相关专家组成，负责本辖区TB/HIV双重感染防治技术指导，组织专业培训，实施疫情监测和数据的统计分析，制订疑难病例诊断、治疗方案，开展不良反应处理等工作。
（二）职责分工。
1．艾滋病防治机构职责。
（1）为随访的艾滋病病毒感染者和病人常规提供结核病可疑症状问卷筛查，并将问卷筛查阳性者转介到属地结核病防治机构进行检查。
（2）为新报告的和随访的艾滋病病毒感染者和病人每年至少安排1次结核病检查。
（3）对结核病防治机构送检的结核病人血液标本进行HIV抗体检测，并将检测结果反馈给结核病防治机构。
（4）为TB/HIV双重感染病人提供免费艾滋病抗病毒治疗和随访管理服务。
（5）按规定时限和要求将TB/HIV双重感染相关信息录入艾滋病综合防治信息系统；向结核病防治机构提供与TB/HIV双重感染有关的艾滋病信息。
2．结核病防治机构职责。
（1）为艾滋病防治机构转介的艾滋病病毒感染者和病人提供结核病痰涂片和胸部X线检查服务，并将检查和诊断结果反馈给艾滋病防治机构。
（2）动员艾滋病高、中流行县（区）新登记的结核病病人接受HIV抗体检测，采集血液标本并送艾滋病检测实验室检测；动员艾滋病低流行县（区）有艾滋病高危行为的结核病病人接受HIV抗体检测，采集血液标本并送艾滋病检测实验室检测。对不能采集病人血液标本的机构，转介病人到艾滋病防治机构进行HIV抗体检测。
（3）对TB/HIV双重感染病人提供免费的抗结核治疗和随访管理服务。
（4）按规定时限和要求将结核病病人HIV抗体检测结果及TB/HIV双重感染病人的结核病治疗相关信息录入结核病管理信息系统。
四、工作内容
（一）在艾滋病病毒感染者和病人中开展结核病问卷筛查和检查。 艾滋病防治机构应当对随访的艾滋病病毒感染者和病人进行常规的结核病可疑症状问卷筛查。症状筛查阳性时，如自身不具备检查能力，须转介到结核病防治机构进行结核病检查（详见附件1、2）。
艾滋病防治机构应当将新报告的艾滋病病毒感染者和病人转介到结核病防治机构进行结核病检查。随访的艾滋病病毒感染者和病人无论有无结核病可疑症状，艾滋病防治机构应当每年至少为其安排1次结核病检查。
结核病防治机构对艾滋病防治机构转介的艾滋病病毒感染者和病人开展结核病检查，检查内容包括痰涂片和胸部X线检查，并将检查结果反馈给艾滋病防治机构。
（二）在结核病病人中开展HIV抗体检测。 以县（区）为单位，在艾滋病高、中流行县（区），结核病防治机构应当主动动员所有新登记的结核病病人（排除已知HIV阳性者）进行HIV抗体检测，并进行必要的采血和送检。
艾滋病防治机构对结核病人血液标本进行HIV抗体检测，并将检测结果反馈给结核病防治机构（详见附件3）。
（三）TB/HIV双重感染病人的治疗管理。 对发现的TB/HIV双重感染病人，应当根据当地的情况，确定治疗管理机构。按照《中国结核病防治规划实施工作指南》和《国家免费艾滋病抗病毒药物治疗手册》的要求，进行抗结核和抗病毒治疗、管理以及随访复查，并做好病人治疗管理和转归的信息登记报告工作。
（四）信息的登记报告与保密。 结核病防治机构和艾滋病防治机构应当及时做好TB/HIV双重感染病人的信息登记和机构间的交流，并将收集的信息录入到结核病管理信息系统和艾滋病综合防治信息系统中，逐步完善信息的登记、报告和报表制度。在结核病管理信息系统和艾滋病综合防治信息系统完善之前，同时实行纸质报表进行年度报告。
结核病防治机构会同艾滋病防治机构，收集汇总TB/HIV双重感染防治工作信息，按照县（区）、市（地）、省（区、市）逐级上报TB/HIV双重感染防治工作报表（详见附件4）。省级汇总表以纸质和电子版形式同时报送中国疾病预防控制中心结核病预防控制中心和性病艾滋病预防控制中心。
确定专人负责病人资料的登记报告和资料保存，做好TB/HIV双重感染的信息保密工作。
（五）宣传和培训。 倡导政府部门的主管领导重视与支持TB/HIV双重感染防治工作，提高大众对TB/HIV双重感染的认识，加强对TB/HIV双重感染的危害、病人发现和治疗等方面的知识宣传。对参加TB/HIV双重感染的防治人员进行系统的培训。
（六）TB/HIV双重感染的感染控制工作。 结核病防治机构和艾滋病防治机构在TB/HIV双重感染防治工作中应当避免艾滋病病毒感染者和病人和结核病病人的交叉感染。在艾滋病防治机构，医护人员接诊结核病或有结核病可疑症状的艾滋病病毒感染者和病人时应当做好自身防护工作；在结核病防治机构，对结核病人进行抽血采样时，应当严格按照《全国艾滋病检测技术规范》，做好艾滋病职业暴露的预防工作。
五、督导评估
各级领导小组每年至少组织1次对本辖区TB/HIV双重感染防治工作的督导检查；上级技术工作组及本级领导小组每半年至少开展1次对本辖区TB/HIV双重感染防治工作的考核评价（指标见附件5）。
附件：1.结核病可疑症状筛查问卷
2.在艾滋病病毒感染者和病人中开展结核病病人发现工作的流程
3.在结核病病人中开展HIV抗体检测工作的流程
4. TB/HIV双重感染防治管理工作年度报表
5. TB/HIV双重感染防治工作考核评价指标
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General Office of the Ministry of Health issued the "National TB / HIV dual infection prevention and control of implementation of the program (Trial Implementation)"
Source: The Chinese Government net at 9:27 on the August 3, 2010
General Office of the Ministry of Health issued the "National TB / HIV dual infection prevention and control of implementation of the program (Trial Implementation)"
Health Office of Disease Control issued 〔2010〕 126
Provinces, autonomous regions and municipalities health bureau, health bureau of Xinjiang Production and Construction Corps, the Chinese Centre for Disease Control and Prevention:
TB patients with HIV and opportunistic infections common and major causes of death, of tuberculosis in HIV-infected patients was significantly higher than the general population. TB / HIV dual infection of TB prevention and treatment has become a major challenge, while a serious impact on AIDS prevention and control work. To further strengthen the prevention and treatment of TB and AIDS, effective response to TB / HIV dual infection, the ministry formulated the "National TB / HIV dual infection prevention and control of implementation of the program (for trial)." Is issued to you, please refer to the Executive.
National TB / HIV dual infection
Implementation of prevention and control program (Trial)
TB / HIV dual infection (hereinafter referred to as TB / HIV dual infection) is the prevention of tuberculosis and AIDS, the severe challenges, in order to further strengthen the National TB / HIV dual infection prevention and control, specially formulated the following implementation.
First, the objectives
Establish and improve national TB / HIV dual infection prevention and control mechanisms to TB / HIV dual infection in patients increase the intensity of detection, treatment and management, and control the further spread of TB and AIDS, to protect public health.
Second, control strategies
(A) to strengthen cooperation Cure and Prevention, TB and AIDS control agencies to establish mechanisms of cooperation, fully rely on TB / HIV dual infection in fixed treatment facilities to conduct a joint TB / HIV dual infection of the work.
(B) as the new discovery and follow-up of HIV and TB patients, screening, and screening questionnaire.
(C) for AIDS high, endemic counties (districts) of TB patients newly registered HIV antibody testing services.
(D) TB / HIV dual infection in patients with timely and appropriate treatment and follow-up management services.
Third, organizational leadership and the division of responsibilities
(A) organization and leadership.
Led by the health administrative departments at all levels, the establishment of TB / HIV dual infection prevention and control leading group and technical working group, together with AIDS prevention and tuberculosis control institutions agencies specifically responsible for organizing and coordinating and liaison work.
Leading group health administrative departments at all levels, disease prevention and control institutions and medical institutions and other relevant leaders, is responsible for organizing and coordinating the district TB / HIV dual infection prevention, the annual work plan to formulate and implement prevention and treatment funding to carry out monitoring, evaluation, etc. work.
Technical Working Group on TB prevention and control institutions at all levels, AIDS prevention and control agencies and TB / HIV dual infection in fixed treatment facilities and other related experts, in charge of the district TB / HIV dual infection prevention and control of technical guidance, professional training organizations, the implementation of surveillance and data statistics analysis, formulation of difficult cases the diagnosis, treatment, handling of adverse reactions to carry out the work.
(B) the division of responsibilities.
1. AIDS agency responsibilities.
(1) for the follow-up of HIV infected persons and to provide TB patients with suspicious symptoms questionnaire routine screening, and positive screening questionnaire referred to the territorial organization of tuberculosis prevention and control checks.
(2) for the new report and follow-up of patients with HIV and TB at least annually arrange a time check.
(3) of the tuberculosis control agencies for inspection of blood samples of TB HIV antibody test, and results fed back to TB control institutions.
(4) for the TB / HIV dual infection in AIDS patients with free antiretroviral treatment and follow-up management services.
(5) the set deadline and requested that TB / HIV dual infection prevention and control of AIDS-related information into the information system; to tuberculosis prevention and control agencies and TB / HIV dual infection of HIV-related information.
2. TB prevention and control agency responsibilities.
(1) referrals from AIDS infected with HIV and tuberculosis patients sputum smear and chest X-ray services, and the results fed back to the screening and diagnosis of AIDS organizations.
(2) mobilization of AIDS, high, medium and popular county (district) of TB patients newly registered HIV antibody test, blood samples were collected and sent to AIDS testing laboratory; mobilization of low HIV prevalence counties (districts) with high-risk behavior of HIV TB patients HIV antibodies, blood samples were collected and sent to HIV testing laboratory. Collected blood samples of patients who can not institutions, refer patients to the AIDS HIV antibody testing agencies.
(3) of the TB / HIV dual infection in patients free of tuberculosis treatment and follow-up management services.
(4) the set deadline and requested that TB patients HIV antibody test results and the TB / HIV dual infection of TB patients in TB treatment-related information into the management information system.
Fourth, work
(A) in patients with HIV infection and to carry out TB screening questionnaire and examination. AIDS prevention and control institutions shall follow-up of HIV infected persons and patients with suspicious symptoms of routine TB screening questionnaire. Screening for positive symptoms, such as when their own do not have the inspection capacity, should be referred to the TB TB examination bodies (see annex 1,2).
AIDS prevention and control institutions shall report to the new HIV infection and TB patients referred to the TB inspection agencies. Follow-up of HIV infected persons and patients with or without suspicious symptoms of TB, AIDS prevention and control agencies should arrange for at least 1 year of tuberculosis examination.
AIDS prevention and tuberculosis control agency referrals from HIV and TB patients in the examination, including sputum smear examination and chest X-ray examination and test results back to AIDS organizations.
(B) carry out HIV in TB patients antibodies. The county (district) as a unit, in the AIDS high, endemic counties (districts), tuberculosis prevention and control agencies should take the initiative to mobilize all newly registered TB patients (exclusion of known HIV-positive) for HIV antibody testing, and necessary blood and submission.
AIDS and TB prevention and control institutions to conduct HIV antibody testing of blood samples and test results back to the TB control institutions (see Annex 3).
(C) TB / HIV dual infection in patient treatment management. The discovery of the TB / HIV coinfected patients should be based on local conditions, determine the treatment administration. Accordance with the "Guide to the implementation of tuberculosis control program" and "national free antiretroviral treatment of AIDS Manual" requirements, for anti-tuberculosis and anti-viral treatment, management and follow-up review, and good management of patient treatment and outcome information registration report work.
(D) the registration of the report and confidential information. AIDS prevention and tuberculosis control agencies and institutions shall promptly make TB / HIV dual infection in patient registration and information sharing among agencies, and information gathered input to the TB management information systems and AIDS prevention and control information system and gradually improve the registration information , reporting and reporting system. TB management information systems and improve AIDS prevention and control information system before, while the implementation of the annual report of paper statements.
TB prevention and control agencies, together with AIDS prevention and control agencies to collect aggregate TB / HIV dual infection prevention information, according to county (district) and municipal (prefecture), provincial (regional, municipal) level by level TB / HIV dual infection prevention and control statements (see Annex 4). Provincial summary in paper and electronic form at the same time submitted to the China Centre for Disease Control and Prevention Tuberculosis Prevention and Control Center and the prevention of STD and AIDS Control Centre.
Identify staff for the registration of patient data reporting and data retention, good TB / HIV dual infection information confidential.
(E) promotion and training. Government departments in charge of promoting leadership attention and support of TB / HIV dual infection prevention and control of public awareness on TB / HIV dual infection of understanding, to strengthen TB / HIV dual infection hazards, detection and treatment of patients in the areas of propaganda. Participating in TB / HIV dual infection control personnel training system.
(F) TB / HIV dual infection of infection control. AIDS prevention and tuberculosis control agencies and institutions in the TB / HIV dual infection prevention and control work should be avoided and patients infected with HIV and TB patient cross-infection. In AIDS prevention and control institutions, medical admissions suspected TB or TB symptoms of HIV infection and the patients should do self-protection work; in TB prevention and control body, blood sampling for TB, should be strictly in accordance with the "National AIDS test specifications, "occupational exposure in AIDS prevention.
5, supervision and evaluation
The leadership group at least annually organize a meeting on this area TB / HIV dual infection prevention and control of supervision and inspection; superior technical working group and the level leading group every six months at least conduct a meeting on the district TB / HIV dual infection prevention and control assessment evaluation ( indicators see Annex 5).
Annex: 1. Suspicious symptoms of TB screening questionnaire
2. In patients infected with HIV and TB patients found to carry out the work process
3. In TB patients, HIV antibody testing to carry out the work process
4. TB / HIV dual infection control management of the annual report
5. TB / HIV dual infection prevention Evaluation Index
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