Pitchenik A E, Fertel D, Bloch A B
University of Miami Medical Center, Florida.
Clin Chest Med. 1988 Sep;9(3):425-41.
TB is common in the setting of HIV-induced immunosuppression, especially among demographic groups with a high background prevalence of tuberculous infection. It is often the first (sentinel) infectious disease to appear, extrapulmonary and disseminated disease is common, the chest x-ray picture is frequently atypical, and the tuberculin skin test is often falsely negative. It therefore requires a high index of suspicion and an aggressive diagnostic approach to avoid missing HIV-related tuberculous disease, which is communicable from man to man by the aerosol route and which appears to be highly treatable with conventional anti-TB drugs. Identification and INH prophylaxis of tuberculous-infected, HIV-seropositive persons is likely to be very important in the prevention of tuberculous disease. MAI is also a very common pathogen that frequently produces extrapulmonary and disseminated disease among patients with AIDS. In contrast to TB, AIDS-related MAI disease occurs more uniformly among the AIDS risk groups, occurs late among the HIV-related infections, and is not effectively treated with current drug regimens.
结核病在HIV引起的免疫抑制情况下很常见，尤其是在结核感染背景患病率高的人群中。它常常是首个出现的（哨兵）传染病，肺外和播散性疾病很常见，胸部X光片表现常常不典型，结核菌素皮肤试验常常呈假阴性。因此，需要高度的怀疑指数和积极的诊断方法，以避免漏诊与HIV相关的结核病，这种病可通过空气传播在人与人之间传染，而且似乎用传统抗结核药物治疗效果很好。识别结核感染的HIV血清阳性者并对其进行异烟肼预防，对于预防结核病可能非常重要。鸟分枝杆菌也是一种非常常见的病原体，在艾滋病患者中常常引起肺外和播散性疾病。与结核病不同，与艾滋病相关的鸟分枝杆菌病在艾滋病风险群体中发病更一致，在与HIV相关的感染中出现较晚，并且目前的药物治疗方案对其治疗效果不佳。
