艾滋病毒感染者中的结核病感染与预防情况
Landscape of TB Infection and Prevention among People Living with HIV.
作者信息
Vasiliu Anca, Abelman Rebecca, Kherabi Yousra, Iswari Saktiawati Antonia Morita, Kay Alexander
机构信息
Global TB Program, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94110, USA.
出版信息
Pathogens. 2022 Dec 16;11(12):1552. doi: 10.3390/pathogens11121552.
Tuberculosis (TB) is one of the leading causes of mortality in people living with HIV (PLHIV) and contributes to up to a third of deaths in this population. The World Health Organization guidelines aim to target early detection and treatment of TB among PLHIV, particularly in high-prevalence and low-resource settings. Prevention plays a key role in the fight against TB among PLHIV. This review explores TB screening tools available for PLHIV, including symptom-based screening, chest radiography, tuberculin skin tests, interferon gamma release assays, and serum biomarkers. We then review TB Preventive Treatment (TPT), shown to reduce the progression to active TB and mortality among PLHIV, and available TPT regimens. Last, we highlight policy-practice gaps and barriers to implementation as well as ongoing research needs to lower the burden of TB and HIV coinfection through preventive activities, innovative diagnostic tests, and cost-effectiveness studies.
结核病（TB）是艾滋病毒感染者（PLHIV）死亡的主要原因之一，在该人群中导致的死亡人数占比高达三分之一。世界卫生组织的指南旨在针对PLHIV中的结核病进行早期检测和治疗，尤其是在高流行率和资源匮乏地区。预防在PLHIV结核病防治中起着关键作用。本综述探讨了可用于PLHIV的结核病筛查工具，包括基于症状的筛查、胸部X光检查、结核菌素皮肤试验、干扰素γ释放试验和血清生物标志物。然后，我们回顾了已证明可降低PLHIV发展为活动性结核病和死亡率的结核病预防性治疗（TPT）以及可用的TPT方案。最后，我们强调了政策与实践之间的差距以及实施障碍，以及通过预防活动、创新诊断测试和成本效益研究来降低结核病和艾滋病毒合并感染负担的持续研究需求。
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