Zacarías F, González R S, Cuchí P, Yáñez A, Peruga A, Mazín R, Betts C, Weissenbacher M
Pan American Health Organization, Regional Program for AIDS and Sexually Transmitted Diseases, Washington, D.C.
Bull Pan Am Health Organ. 1994 Dec;28(4):312-23.
At present, human immunodeficiency virus (HIV) is thought to have infected over 17 million people worldwide, over 1 million in North America and roughly 2 million in Latin America and the Caribbean. By comparison, infection with the tuberculosis (TB) agent Mycobacterium tuberculosis is far more common, current estimates indicating that roughly one-third of the world's population is infected. These two infections tend to aggravate each other. That is, HIV leads to a progressive immune system depression that favors reactivation of TB in people with latent tuberculous infections; it promotes progression of TB primary infections or reinfections to full-blown tuberculous disease; and it fosters TB transmission, because those simultaneously infected with HIV and M. tuberculosis tend to develop a bacilliferous and contagious TB that can be transmitted to other susceptible individuals, even though the latter are HIV-negative. In addition, this coinfection tends to promote circulation of drug-resistant M. tuberculosis and to produce peculiar manifestations that complicate TB diagnosis, treatment, and control. Overall, it seems clear that the growing threat posed by these associated agents demands effective action in the form of well-coordinated measures involving throughgoing participation by all countries.
目前，据认为人类免疫缺陷病毒（HIV）已在全球感染了超过1700万人，在北美超过100万人，在拉丁美洲和加勒比地区约200万人。相比之下，结核分枝杆菌引发的结核病感染更为常见，目前估计表明全球约三分之一的人口受到感染。这两种感染往往会相互加剧。也就是说，HIV会导致免疫系统逐渐衰退，这有利于潜伏性结核感染患者体内结核杆菌的重新激活；它会促使原发性结核感染或再感染发展为全面的结核病；并且它会促进结核病的传播，因为同时感染HIV和结核分枝杆菌的人往往会患上带有杆菌且具有传染性的结核病，这种结核病可以传播给其他易感个体，即使后者是HIV阴性。此外，这种合并感染往往会促进耐药结核分枝杆菌的传播，并产生使结核病诊断、治疗和控制复杂化的特殊表现。总体而言，这些相关病原体构成的威胁日益增大，这似乎表明需要采取有效行动，即通过所有国家全面参与的协调措施来应对。
