Onyebujoh Philip Chukwuka, Ribeiro Isabela, Whalen Christopher Curtis
United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland.
J Infect Dis. 2007 Aug 15;196 Suppl 1(Suppl 1):S35-45. doi: 10.1086/518657.
The vicious interaction between the human immunodeficiency virus (HIV) infection and tuberculosis (TB) pandemics poses special challenges to national control programs and individual physicians. Although recommendations for the treatment of TB in HIV-infected patients do not significantly differ from those for HIV-uninfected patients, the appropriate management of HIV-associated TB is complicated by health system issues, diagnostic difficulties, adherence concerns, overlapping adverse-effect profiles and drug interactions, and the occurrence of paradoxical reactions after the initiation of effective antiretroviral therapy. In this article, recommended treatment strategies and novel approaches to the management of HIV-associated TB are reviewed, including adjuvant treatment and options for treatment simplification. A focused research agenda is proposed in the context of the limitations of the current knowledge framework.
人类免疫缺陷病毒(HIV)感染与结核病(TB)大流行之间的恶性循环给国家防控计划和个体医生带来了特殊挑战。尽管针对HIV感染患者的结核病治疗建议与未感染HIV患者的治疗建议并无显著差异,但由于卫生系统问题、诊断困难、依从性问题、不良反应谱重叠和药物相互作用,以及在开始有效的抗逆转录病毒治疗后出现矛盾反应,HIV相关结核病的适当管理变得复杂。本文综述了HIV相关结核病管理的推荐治疗策略和新方法,包括辅助治疗和简化治疗方案。在当前知识框架存在局限性的背景下,提出了一个重点研究议程。