Hamilton CD
Duke University Medical Center and the Durham VA Medical Center, Box 3306, Durham, NC 27710, USA.
Curr Infect Dis Rep. 1999 Apr;1(1):80-88. doi: 10.1007/s11908-999-0014-6.
The resurgence in cases of active tuberculosis in North America in the past decade has prompted increases in funding for tuberculosis treatment, research, and education. As a result, the number of new cases of tuberculosis has declined and cases occur in smaller pockets of well-characterized populations, such as communities of foreign-born persons and socioeconomically disadvantaged groups. New strategies for the treatment of both active and latent tuberculosis may soon include the newly licensed, long-acting rifamycin, rifapentine, but further studies are needed to determine optimal dosing regimens for this agent. Experts in tuberculosis and HIV infection have made headway in defining the optimal therapy for each current therapeutic option, and recently published guidelines are a useful document for clinicians. Rifabutin-based regimens are one approach toward achieving the optimal treatment of both diseases simultaneously. Finally, newly licensed molecular diagnostic tests for direct use on clinical specimens are intriguing, but their clinical utility remains to be defined.
过去十年北美活动性肺结核病例的再度出现促使用于结核病治疗、研究和教育的资金增加。因此，结核病新发病例数量有所下降，且病例出现在特征明确的较小人群中，比如外国出生人群社区和社会经济弱势群体。治疗活动性和潜伏性结核病的新策略可能很快会包括新获批的长效利福霉素利福喷丁，但还需要进一步研究以确定该药物的最佳给药方案。结核病和HIV感染方面的专家在确定每种现有治疗方案的最佳疗法上取得了进展，最近发布的指南对临床医生来说是一份有用的文件。基于利福布汀的治疗方案是同时实现两种疾病最佳治疗的一种方法。最后，新获批的可直接用于临床标本的分子诊断测试很吸引人，但其临床效用仍有待确定。
