Procop Gary W
Staff, Pathology and Clinical Microbiology, Cleveland Clinic, 9500 Euclid Avenue/LL2-2, Cleveland, OH 44195, United States.
Semin Diagn Pathol. 2017 Jul;34(4):332-339. doi: 10.1053/j.semdp.2017.04.006. Epub 2017 Apr 12.
The importance of mycobacteria as opportunistic pathogens, particularly members of the M. avium complex (MAC), in patients with progressive HIV infection was recognized early in the AIDS epidemic. It took longer to appreciate the global impact and devastation that would result from the deadly synergy that exists between HIV and M. tuberculosis. This HIV/M. tuberculosis co-pandemic is ongoing and claiming millions of lives every year. In addition to MAC, a number of other non-tuberculous mycobacteria have been recognized as opportunistic pathogens in HIV-infected individuals; some of these are more commonly encountered (e.g., M. kansasii) than others (M. haemophilum and M. genevense). Finally, there are challenges to concomitantly treating the HIV and the infecting Mycobacterium species, because of antimicrobial resistance, therapeutic side-effects and the complex pharmacologic interactions of the antiretroviral and antimycobacterial multidrug therapy.
在艾滋病流行早期，人们就认识到分枝杆菌作为机会性病原体的重要性，尤其是鸟分枝杆菌复合群（MAC）的成员，对于进展性HIV感染患者而言。人们花了更长时间才认识到HIV与结核分枝杆菌之间存在的致命协同作用所带来的全球影响和破坏。这种HIV/结核分枝杆菌共同大流行仍在持续，每年夺去数百万人的生命。除了MAC，其他一些非结核分枝杆菌也被认为是HIV感染者中的机会性病原体；其中一些比其他的（嗜血性分枝杆菌和日内瓦分枝杆菌）更常见（例如堪萨斯分枝杆菌）。最后，由于抗菌药物耐药性、治疗副作用以及抗逆转录病毒和抗分枝杆菌多药疗法复杂的药物相互作用，同时治疗HIV和感染的分枝杆菌物种存在挑战。
