肝移植受者中的潜伏性结核分枝杆菌感染——当前诊断与管理中的争议
Latent Mycobacterium tuberculosis Infection in Liver Transplant Recipients-Controversies in Current Diagnosis and Management.
作者信息
Rajagopala Srinivas, Olithselvan A, Varghese Joy, Shanmugam Naresh, Rela Mohamed
机构信息
Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
出版信息
J Clin Exp Hepatol. 2011 Jun;1(1):34-7. doi: 10.1016/S0973-6883(11)60120-5. Epub 2011 Aug 26.
Liver transplantation for end-stage liver disease is increasingly being undertaken in India.(1) Routine tuberculin skin testing (TST) for latent Mycobacterium tuberculosis infection (LTBI) and isoniazid prophylaxis in TST-positive liver-transplant recipients (LTRs) is recommended(2,3) but seldom implemented worldwide.(4-7) The role of TST-testing and isoniazid prophylaxis in LTRs remains further undefined in high prevalence areas, including India. We describe the burden of LTBI in LTRs; the epidemiological aspects of M. tuberculosis infection in high prevalence areas; identifiable risk factors for M. tuberculosis infection; the limitations of current diagnostic techniques for LTBI in LTRs and the efficacy and toxicity of isoniazid prophylaxis in TST-positive LTRs and suggest directions for future investigations in this area.
在印度，终末期肝病的肝移植手术开展得越来越多。（1）对于潜在结核分枝杆菌感染（LTBI），推荐对肝移植受者（LTRs）进行常规结核菌素皮肤试验（TST），并对TST阳性的LTRs进行异烟肼预防治疗（2,3），但在全球范围内很少实施。（4-7）在包括印度在内的高流行地区，TST检测和异烟肼预防治疗在LTRs中的作用仍有待进一步明确。我们描述了LTRs中LTBI的负担；高流行地区结核分枝杆菌感染的流行病学特征；结核分枝杆菌感染的可识别危险因素；LTRs中当前LTBI诊断技术的局限性以及TST阳性LTRs中异烟肼预防治疗的疗效和毒性，并提出该领域未来研究的方向。
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