Glynn J R
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Br Med Bull. 1998;54(3):579-93. doi: 10.1093/oxfordjournals.bmb.a011712.
Tuberculosis is increasing in many countries. In some areas the major influences on tuberculosis trends are the traditional ones: poverty, failures in the treatment system, and immigration. In others, and increasingly, the HIV epidemic is having a huge impact. HIV infection increases the risk of tuberculosis approximately 7-fold, though this may vary with the stage of the HIV epidemic, the prevalence of tuberculosis, and the age groups considered. Dually-infected individuals develop tuberculous disease at a rate of 5-10% per year. HIV also increases the risk of disease following recent infection, which makes a major contribution to the tuberculosis burden in some settings. HIV-infected individuals, may transmit Mycobacterium tuberculosis less than do HIV-negative individuals, but the extra cases will add to the transmission overall, and evidence of HIV-attributable increases in the annual risk of infection is beginning to be seen.
许多国家的结核病发病率正在上升。在一些地区，对结核病趋势的主要影响是传统因素：贫困、治疗体系不完善以及移民。在其他地区，而且这种情况越来越多，艾滋病流行正产生巨大影响。感染艾滋病毒会使患结核病的风险增加约7倍，不过这可能因艾滋病流行阶段、结核病患病率以及所考虑的年龄组不同而有所差异。双重感染者每年患结核病的比率为5%至10%。艾滋病毒还会增加近期感染后患结核病的风险，这在某些情况下对结核病负担有重大影响。感染艾滋病毒的个体传播结核分枝杆菌的能力可能低于未感染艾滋病毒的个体，但这些额外的病例会增加总体传播，而且已经开始出现可归因于艾滋病毒导致年度感染风险增加的证据。
