Styblo K
International Union Against Tuberculosis and Lung Disease, Paris, France.
Bull Int Union Tuberc Lung Dis. 1991 Mar;66(1):27-32.
HIV is the strongest risk factor for tuberculous disease observed in the last 100 years in subjects infected with tubercle bacilli. Its impact upon tuberculosis incidence is so great that it has disrupted the balance between the tubercle bacillus and the community. The breakdown rate from tuberculous infection to active tuberculosis in persons infected dually is at least 30%. Although adequate chemoprophylaxis would prevent a considerable number of tuberculosis cases among these individuals, its application is not feasible in developing countries with a high prevalence of both tuberculous and HIV infections. Thus it seems that very little can be done against the increase in the incidence of tuberculosis caused by HIV. The only feasible measure to contain the transmission of tuberculous infection is to achieve a high cure rate and a high detection rate of smear-positive and other cases. This would enable us to contain-to an extent-the transmission of tuberculous infection. The results of IUATLD assisted National Tuberculosis Programmes in Tanzania and Malawi show that this can be achieved.
在过去100年中，艾滋病毒是结核杆菌感染人群中观察到的患结核病最强的风险因素。它对结核病发病率的影响非常大，以至于打破了结核杆菌与群体之间的平衡。双重感染者从结核感染发展为活动性结核病的转化率至少为30%。尽管适当的化学预防可预防这些人中相当数量的结核病例，但在结核和艾滋病毒感染率都很高的发展中国家，应用化学预防并不可行。因此，对于艾滋病毒导致的结核病发病率上升似乎几乎无能为力。控制结核感染传播的唯一可行措施是实现高治愈率以及涂片阳性和其他病例的高检出率。这将使我们能够在一定程度上控制结核感染的传播。国际防痨和肺部疾病联盟协助的坦桑尼亚和马拉维国家结核病规划的结果表明这是可以实现的。
