Infectious Disease, University of Pennsylvania, Philadelphia, USA.
Curr HIV/AIDS Rep. 2011 Sep;8(3):153-63. doi: 10.1007/s11904-011-0083-7.
The diagnosis of latent and active tuberculosis in the HIV-positive population is challenged by diminished sensitivity of conventional tests, atypical presentations, and the lack of culture methods in the developing world, where the burden of co-infection is greatest. In response to these challenges, a variety of new diagnostics have emerged. These include interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection and novel culture methods and molecular assays for the diagnosis of active tuberculosis. Although some tests (such as interferon-gamma release assays) are not clearly superior to existing diagnostics, other novel diagnostics, such as real-time polymerase chain reaction and the microscopic observed direct susceptibility assay hold much promise for prompt and accurate TB diagnosis in this population. Line-probe, nitrate reductase, and mycobacteriophage assays have also provided rapid alternatives to conventional time-consuming drug susceptibility testing and are critical to curtailing the spread of multidrug-resistant TB.
在 HIV 阳性人群中，由于传统检测方法的敏感性降低、不典型表现以及发展中国家缺乏培养方法，潜伏性和活动性结核病的诊断面临挑战，而这些国家的合并感染负担最大。为了应对这些挑战，出现了各种新的诊断方法。这些方法包括用于诊断潜伏性结核（TB）感染的干扰素-γ释放检测，以及用于诊断活动性结核病的新型培养方法和分子检测。虽然某些检测方法（如干扰素-γ释放检测）并不明显优于现有诊断方法，但其他新型诊断方法，如实时聚合酶链反应和直接观察药敏试验，在该人群中快速、准确地诊断结核病方面具有很大的潜力。线探针、硝酸盐还原酶和分枝杆菌噬菌体检测也为传统耗时的药敏试验提供了快速替代方法，对于遏制耐多药结核病的传播至关重要。
