Beaulieu P, Molina J M, Rouveau M, Garrait V, Casin I, Doco-Lecompte T, Lagrange P, Decazes J M, Modaï J
Clinique des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris.
Ann Med Interne (Paris). 1993;144(5):323-8.
This retrospective study compared the epidemiological, clinical and bacteriological characteristics of tuberculosis in HIV-infected (HIV+) and seronegative (HIV-) patients in France. It included 67 cases of tuberculosis observed in the hospital setting between 1985 and 1990. The 35 HIV+ patients (52.2%) were more frequently of European origin, while those of African origin were HIV-. Disseminated tuberculosis predominated in HIV+ patients, as opposed to pulmonary tuberculosis in HIV- patients. The tuberculin test was more often positive in HIV- patients than in HIV+ ones (65.6 versus 17.1%; p < 0.001). Direct bacteriological examination of the sputum was positive more frequently in HIV- than HIV+ patients (56.2 versus 22.8%; p < 0.01). A high percentage of the Mycobacterium tuberculosis strains isolated from HIV+ patients (20%) was resistant to anti-tuberculous drugs, primarily isoniazid, while no resistance was found in HIV- patients. The initial response to treatment and the therapy-associated side effects did not differ between the two groups. Four relapses (11.4%) occurred in HIV+ patients, raising the question of the indication of drug prophylaxis following tuberculosis in HIV-infected patients.
这项回顾性研究比较了法国HIV感染（HIV+）和血清学阴性（HIV-）患者结核病的流行病学、临床和细菌学特征。研究纳入了1985年至1990年间在医院观察到的67例结核病病例。35例HIV+患者（52.2%）中欧洲裔更为常见，而非洲裔患者为HIV-。播散性结核病在HIV+患者中占主导，而HIV-患者中则以肺结核为主。HIV-患者结核菌素试验阳性率高于HIV+患者（65.6%对17.1%；p<0.001）。HIV-患者痰液直接细菌学检查阳性率高于HIV+患者（56.2%对22.8%；p<0.01）。从HIV+患者分离出的结核分枝杆菌菌株中有较高比例（20%）对抗结核药物耐药，主要是对异烟肼耐药，而HIV-患者中未发现耐药情况。两组患者对治疗的初始反应及治疗相关副作用无差异。HIV+患者中有4例复发（11.4%），这引发了HIV感染患者结核病后药物预防指征的问题。
