潜伏性结核分枝杆菌感染的治疗和抗逆转录病毒疗法在结核病预防中的应用。
Treatment of latent M. tuberculosis infection and use of antiretroviral therapy to prevent tuberculosis.
机构信息
Vanderbilt University Medical Center, Division of Infectious Diseases, Department of Medicine, Nashville, Tennessee, USA.
Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
J Clin Invest. 2020 Oct 1;130(10):5102-5104. doi: 10.1172/JCI137294.
Even with treatment of HIV with antiretroviral therapy (ART), the risk of tuberculosis (TB) reactivation remains higher in HIV-infected than HIV-uninfected persons. In this issue of the JCI, Ganatra et al. explored TB reactivation in the context of ART using TB and simian immunodeficiency virus-coinfected (TB/SIV-coinfected) nonhuman primates. The authors found that treating rhesus macaques with ART restored CD4+ T cells in whole blood, spleen, and bronchoalveolar lavage (BAL) fluid, but not in the lung interstitium. TB risk was not decreased in the coinfected macaques treated with ART for 14-63 days, suggesting that ART does not decrease the short-term risk of reactivation. Reactivation occurred as CD4+ T cells were increasing, which is consistent with observations made in humans. This study provides a potential model for systematic evaluation of TB/SIV coinfection and different treatment regimens and strategies to prevent TB reactivation.
即使采用抗逆转录病毒疗法（ART）治疗 HIV，HIV 感染者发生结核分枝杆菌（TB）再激活的风险仍高于 HIV 未感染者。在本期 JCI 中，Ganatra 等人研究了在 ART 背景下，TB 和猴免疫缺陷病毒（SIV）合并感染（TB/SIV 合并感染）的非人类灵长类动物中 TB 的再激活情况。作者发现，ART 治疗可恢复恒河猴全血、脾脏和支气管肺泡灌洗液（BAL）中的 CD4+T 细胞，但不能恢复肺间质中的 CD4+T 细胞。在接受 ART 治疗 14-63 天的合并感染恒河猴中，TB 风险并未降低，这表明 ART 并不能降低短期再激活的风险。再激活发生在 CD4+T 细胞增加时，这与在人类中观察到的结果一致。这项研究为系统评估 TB/SIV 合并感染以及不同治疗方案和策略预防 TB 再激活提供了一种潜在的模型。
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