新生儿和幼儿中的HIV相关结核病
HIV-Associated Tuberculosis in the Newborn and Young Infant.
作者信息
Adhikari M, Jeena P, Bobat R, Archary M, Naidoo K, Coutsoudis A, Singh R, Nair N
机构信息
Neonatal Team, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, P.O. Box 17049, Congella, Durban 4013, South Africa.
出版信息
Int J Pediatr. 2011;2011:354208. doi: 10.1155/2011/354208. Epub 2011 Apr 4.
Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB) and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases.
每年约有25万妇女在孕期、分娩期或产后死亡。在撒哈拉以南非洲地区，结核病（TB）和艾滋病毒导致的孕产妇死亡率现已超过产科相关的死亡原因。大多数病例发生在非洲和亚洲结核病流行的人口密集地区。结核病的垂直传播率为15%，在资源有限地区采用单一或联合抗逆转录病毒疗法时，艾滋病毒的总体垂直传播率在1.9%至10.7%之间。若要实现千年发展目标，必须预防艾滋病毒和结核病。新生儿结核病预防和检测的关键在于产妇病史以及母亲艾滋病毒检测呈阳性。即便对这两种疾病进行治疗，围产期结局仍不容乐观。建议纯母乳喂养。其对社区和社会的影响极为严重。社会问题使这两种疾病的预后更加恶化。
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