Luetkemeyer Anne F
University of California San Francisco, San Francisco, CA, USA.
Top HIV Med. 2010 Oct-Nov;18(4):143-8.
Approximately 10% of new cases of tuberculosis (TB) in the United States occur in HIV-infected persons. HIV infection dramatically increases the risk of TB, and this increased risk is present throughout the course of HIV infection. TB and HIV coinfection complicates the course and treatment of both diseases. Isoniazid preventive therapy and antiretroviral therapy both substantially reduce the risk of developing active disease in persons with latent TB infection. Antiretroviral therapy should be given during treatment for active TB, as mortality was reduced by 56% with initiation of antiretroviral therapy before the completion of TB therapy. In addition, for patients with low CD4+ cell counts (less than 200/microm3), starting antiretroviral therapy during the intensive phase of TB treatment reduced mortality by 34% compared with delaying antiretroviral therapy until 8 weeks after TB treatment initiation.
在美国，约10%的新发结核病病例发生在艾滋病毒感染者身上。艾滋病毒感染显著增加了患结核病的风险，而且在艾滋病毒感染的整个过程中这种风险都存在。结核病和艾滋病毒合并感染使两种疾病的病程和治疗变得复杂。异烟肼预防性治疗和抗逆转录病毒治疗都能大幅降低潜伏性结核感染患者发生活动性疾病的风险。抗逆转录病毒治疗应在活动性结核病治疗期间进行，因为在结核病治疗完成前开始抗逆转录病毒治疗可使死亡率降低56%。此外，对于CD4+细胞计数低（低于200/立方毫米）的患者，在结核病治疗的强化阶段开始抗逆转录病毒治疗与将抗逆转录病毒治疗推迟到结核病治疗开始8周后相比，可使死亡率降低34%。
