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结核病-艾滋病病毒合并感染:全球推行抗逆转录病毒治疗二十年后的进展与挑战

Tuberculosis-HIV Co-Infection: Progress and Challenges After Two Decades of Global Antiretroviral Treatment Roll-Out.

作者信息

Letang Emilio, Ellis Jayne, Naidoo Kogieleum, Casas Esther C, Sánchez Paquita, Hassan-Moosa Razia, Cresswell Fiona, Miró Jose M, García-Basteiro Alberto L

机构信息

ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain.

Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Hospital for Tropical Diseases, University College London, London, UK.

出版信息

Arch Bronconeumol. 2020 Jul;56(7):446-454. doi: 10.1016/j.arbr.2019.11.013.

Abstract

Despite wide antiretroviral scale-up during the past two decades resulting in declining new infections and mortality globally, HIV-associated tuberculosis remains as a major public health concern. Tuberculosis is the leading HIV-associated opportunistic infection and the main cause of death globally and, particularly, in resource-limited settings. Several challenges exist regarding diagnosis, global implementation of latent tuberculosis treatment, management of active tuberculosis, delivery of optimal patient-centered TB and HIV prevention and care in high burden countries. In this article we review the advances on pathogenesis, diagnosis, and treatment after nearly two decades of global roll-out of antiretroviral therapy and discuss the current challenges for the global control of tuberculosis-HIV co-infection.

摘要

尽管在过去二十年中广泛扩大了抗逆转录病毒治疗的规模,使得全球新感染病例和死亡率有所下降,但与艾滋病病毒相关的结核病仍然是一个主要的公共卫生问题。结核病是与艾滋病病毒相关的主要机会性感染,也是全球尤其是资源有限地区的主要死亡原因。在高负担国家,在诊断、潜伏性结核病治疗的全球实施、活动性结核病的管理、提供以患者为中心的最佳结核病和艾滋病病毒预防与护理方面存在若干挑战。在本文中,我们回顾了抗逆转录病毒疗法全球推广近二十年后在发病机制、诊断和治疗方面取得的进展,并讨论了全球控制结核病-艾滋病病毒合并感染目前面临的挑战。

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