The South Asian Association for Regional Cooperation - Canada (project funded by the Canadian International Development Agency), Health Canada, Toronto, Ontario.
Can J Infect Dis Med Microbiol. 2007 Sep;18(5):289-91. doi: 10.1155/2007/986794.
Resistance to anti-tuberculosis (TB) drugs continues to present a major challenge to global public health. Resistance usually develops due to inadequate TB management, including improper use of medications, improper treatment regimens and failure to complete the treatment course. This may be due to an erratic supply or a lack of access to treatment, as well as to patient noncompliance. However, the emergence and transmission of drug-resistant TB, including the recently detected extensively drug resistant TB (XDR-TB), is driven, in part, by the synergistic relationship between TB and HIV (TB/HIV coinfection). There is evidence that persons infected with HIV are more likely to experience XDR-TB. XDR-TB is virtually untreatable with available TB medications. XDR-TB presents a grave global public health threat, particularly in high HIV prevalence settings. The present commentary discusses the current status of XDR-TB and draws attention to the urgency in addressing this problem, for both the global and Canadian public health networks. XDR-TB and the apparent XDR-TB and HIV association warrants further study.
抗结核 (TB) 药物耐药性持续对全球公共卫生构成重大挑战。耐药性通常是由于 TB 管理不当引起的，包括药物使用不当、治疗方案不当和未能完成治疗疗程。这可能是由于供应不稳定或无法获得治疗，以及患者不遵守规定。然而，耐药性结核的出现和传播，包括最近发现的广泛耐药性结核 (XDR-TB)，部分是由结核和艾滋病毒 (TB/HIV 合并感染) 之间的协同关系驱动的。有证据表明，感染艾滋病毒的人更有可能出现广泛耐药性结核。现有的结核药物几乎无法治疗广泛耐药性结核。广泛耐药性结核对全球公共卫生构成严重威胁，尤其是在艾滋病毒高发地区。本评论讨论了广泛耐药性结核的现状，并提请注意解决这一问题的紧迫性，这对全球和加拿大公共卫生网络都是如此。广泛耐药性结核以及明显的广泛耐药性结核和艾滋病毒的关联需要进一步研究。
