Chin D P
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital Medical Center, CA 94110.
Semin Respir Infect. 1993 Jun;8(2):124-38.
Since the beginning of the AIDS epidemic, nontuberculous mycobacterial infections have been reported with increasing frequency in HIV-infected patients. Although Mycobacterium avium complex has been responsible for the majority of these infections, an increasing number of other nontuberculous mycobacteria have been reported to cause clinical disease. In spite of initial questions about the clinical significance of disseminated M avium complex infection, it now appears that this infection contributes to the morbidity and mortality of HIV-infected patients. Therefore, recent studies have focused on the use of antimycobacterial drugs to treat or prevent M avium complex bacteremia. These studies have found that drug treatment, especially with the newer macrolides, can decrease bacteremic load and improve debilitating symptoms. Furthermore, rifabutin have been found to decrease or delay the development of M avium complex bacteremia. As HIV-infected patients live longer because of antiviral drugs or prophylaxis against opportunistic infections, nontuberculous mycobacterial infections will likely become increasingly frequent and contribute to substantial morbidity or mortality.
自艾滋病流行开始以来，非结核分枝杆菌感染在HIV感染患者中的报告频率不断增加。虽然鸟分枝杆菌复合群是这些感染的主要病因，但据报告越来越多的其他非结核分枝杆菌也可引起临床疾病。尽管最初对播散性鸟分枝杆菌复合群感染的临床意义存在疑问，但现在看来这种感染会导致HIV感染患者的发病和死亡。因此，最近的研究集中在使用抗分枝杆菌药物来治疗或预防鸟分枝杆菌复合群菌血症。这些研究发现，药物治疗，尤其是使用新型大环内酯类药物，可以降低菌血症负荷并改善虚弱症状。此外，已发现利福布汀可减少或延迟鸟分枝杆菌复合群菌血症的发生。由于抗病毒药物或针对机会性感染的预防措施，HIV感染患者的寿命延长，非结核分枝杆菌感染可能会变得越来越频繁，并导致大量发病或死亡。
