Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Department of Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Am J Trop Med Hyg. 2024 Aug 13;111(4):719-723. doi: 10.4269/ajtmh.23-0637. Print 2024 Oct 2.
The burden of tuberculosis (TB) is disproportionate in tropical and subtropical regions, where parasitic coinfections are common. Given the significant geographical overlap between TB and intestinal parasitic infections, it is important to consider the implications of intestinal parasitic infections for the TB pandemic. Intestinal parasitic infections have been theorized to increase vulnerability to TB by altering the inflammatory milieu, inducing undernutrition that blunts the immune response, and affecting drug pharmacokinetics. In this perspective, we provide a background of the epidemiological and immunological evidence that links parasitic infections to increased risk of TB progression and worse treatment outcomes. We also identify gaps in our knowledge and call for increased research on TB-parasitic coinfections to ensure action on a potentially widespread TB comorbidity.
结核病（TB）的负担在热带和亚热带地区不成比例，这些地区寄生虫合并感染很常见。鉴于 TB 和肠道寄生虫感染之间存在显著的地理重叠，因此需要考虑肠道寄生虫感染对 TB 大流行的影响。寄生虫感染被认为会通过改变炎症环境、导致营养不良从而削弱免疫反应以及影响药物药代动力学，从而增加对 TB 的易感性。在这篇观点文章中，我们提供了流行病学和免疫学证据的背景，这些证据将寄生虫感染与 TB 进展风险增加和治疗结果恶化联系起来。我们还确定了我们知识中的差距，并呼吁加强对 TB-寄生虫合并感染的研究，以确保对潜在广泛的 TB 合并症采取行动。
