Kaiser-Smith J, Condoluci D V
Department of Medicine, University of Medicine and Dentistry of New Jersey--School of Osteopathic Medicine, Stratford.
J Am Osteopath Assoc. 1991 Apr;91(4):377-84.
Patients with human immunodeficiency virus (HIV) infection, with or without the diagnosis of acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC), have an increased incidence of tuberculosis, especially of an extrapulmonary nature. The condition is associated with significant morbidity and mortality. The reported incidence of the combination of tuberculosis and AIDS varies between 4% and 10% of AIDS patients, with a higher incidence noted in the male, inner-city, intravenous-drug-abuser population. Clinical findings may reflect the site of infection, but are often nondiagnostic. Diagnosis often requires biopsy for histopathologic evaluation and tissue culture to document the presence of granulomas and mycobacterial organisms. Universal body fluid precautions among these patients are mandatory, and respiratory isolation should be maintained during diagnostic evaluation and early treatment. These patients usually respond to standard antituberculosis therapy. Physicians should maintain a high index of suspicion of tuberculosis in patients with HIV infection. Conversely, the diagnosis of HIV infection should be considered in patients with unusual manifestations of tuberculosis. Because tuberculosis is one of the few potentially curable infections in the AIDS patient, recognition of its presence is crucial.
感染人类免疫缺陷病毒（HIV）的患者，无论是否诊断为获得性免疫缺陷综合征（AIDS）或AIDS相关综合征（ARC），结核病发病率均会升高，尤其是肺外结核。这种情况与显著的发病率和死亡率相关。据报道，结核病与AIDS并存的发生率在AIDS患者中为4%至10%，在男性、市中心、静脉吸毒人群中发生率更高。临床症状可能反映感染部位，但往往无诊断意义。诊断通常需要进行活检以进行组织病理学评估和组织培养，以证实肉芽肿和分枝杆菌的存在。对这些患者必须采取普遍的体液防护措施，在诊断评估和早期治疗期间应保持呼吸道隔离。这些患者通常对标准抗结核治疗有反应。医生对HIV感染患者应高度怀疑结核病。相反，对有不寻常结核病表现的患者应考虑HIV感染的诊断。由于结核病是AIDS患者少数几种可能治愈的感染之一，认识到其存在至关重要。
