Dokubo E Kainne, Baddeley Annabel, Pathmanathan Ishani, Coggin William, Firth Jacqueline, Getahun Haileyesus, Kaplan Jonathan, Date Anand
MMWR Morb Mortal Wkly Rep. 2014 Nov 28;63(47):1104-7.
Considerable progress has been made in the provision of life-saving antiretroviral therapy (ART) for persons with human immunodeficiency virus (HIV) infection worldwide, resulting in an overall decrease in HIV incidence and acquired immunodeficiency syndrome (AIDS)-related mortality. In the strategic scale-up of HIV care and treatment programs, persons with HIV and tuberculosis (TB) are a priority population for receiving ART. TB is the leading cause of death among persons living with HIV in sub-Saharan Africa and remains a potential risk to the estimated 35 million persons living with HIV globally. Of the 9 million new cases of TB disease globally in 2013, an estimated 1.1 million (13%) were among persons living with HIV; of the 1.5 million deaths attributed to TB in 2013, a total of 360,000 (24%) were among persons living with HIV. ART reduces the incidence of HIV-associated TB disease, and early initiation of ART after the start of TB treatment reduces progression of HIV infection and death among HIV-positive TB patients. To assess the progress in scaling up ART provision among HIV-positive TB patients in 19 countries in sub-Saharan Africa with high TB and HIV burdens, TB and HIV data collected by the World Health Organization (WHO) were reviewed. The results found that the percentage of HIV-positive TB patients receiving ART increased from 37% in 2010 to 69% in 2013. However, many TB cases among persons who are HIV-positive go unreported, and only 38% of the estimated number of HIV-positive new TB patients received ART in 2013. Although progress has been made, the combination of TB and HIV continues to pose a threat to global health, particularly in sub-Saharan Africa.
在为全球感染人类免疫缺陷病毒（HIV）的人群提供挽救生命的抗逆转录病毒疗法（ART）方面已取得了相当大的进展，这使得HIV发病率和获得性免疫缺陷综合征（AIDS）相关死亡率总体下降。在HIV护理和治疗项目的战略扩大规模过程中，HIV合并结核病（TB）患者是接受ART的优先人群。TB是撒哈拉以南非洲HIV感染者的主要死因，并且仍然是全球估计3500万HIV感染者面临的潜在风险。在2013年全球900万新发结核病病例中，估计有110万（13%）是HIV感染者；在2013年归因于TB的150万死亡病例中，共有36万（24%）是HIV感染者。ART可降低HIV相关结核病的发病率，并且在开始TB治疗后尽早启动ART可减少HIV阳性TB患者中HIV感染的进展和死亡。为评估撒哈拉以南非洲19个TB和HIV负担较高国家中HIV阳性TB患者扩大ART治疗的进展情况，对世界卫生组织（WHO）收集的TB和HIV数据进行了审查。结果发现，接受ART的HIV阳性TB患者比例从2010年的37%增至2013年的69%。然而，许多HIV阳性者中的TB病例未报告，2013年估计的HIV阳性新TB患者中只有38%接受了ART。尽管已取得进展，但TB和HIV的合并感染继续对全球健康构成威胁，尤其是在撒哈拉以南非洲。
