Murray J F
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital Medical Center, University of California, USA.
Pneumologie. 1995 Dec;49 Suppl 3:653-6.
The incidence of HIV-associated tuberculosis is increasing worldwide and will continue to increase during the foreseeable future, especially in developing countries. HIV infection appears to increase the opportunity for M. tuberculosis to succeed in causing infection after inhalation into the lungs. Moreover, there is persuasive evidence that in the presence of HIV infection, new-onset tuberculous infection will progress rapidly to clinically significant disease and the likelihood that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is contributing to the increasing incidence of disease caused by multidrug-resistant strains of M. tuberculosis. Neither clinical or radiographic features reliably distinguish the majority of patients with HIV-associated tuberculosis from those who are non-HIV-infected. The remainder, however, may have atypical manifestations and be difficult to diagnose. Six months of chemotherapy with conventional antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.
全球范围内，与艾滋病病毒相关的结核病发病率正在上升，在可预见的未来还将继续增加，尤其是在发展中国家。艾滋病病毒感染似乎增加了结核分枝杆菌吸入肺部后成功引发感染的机会。此外，有确凿证据表明，在存在艾滋病病毒感染的情况下，新发生的结核感染会迅速发展为具有临床意义的疾病，潜伏性结核感染重新激活的可能性也大大增加。艾滋病病毒感染的加速和放大作用导致了耐多药结核分枝杆菌引起的疾病发病率不断上升。大多数合并艾滋病病毒的结核病患者与未感染艾滋病病毒的患者相比，其临床或影像学特征均无法可靠区分。然而，其余患者可能有非典型表现，难以诊断。使用传统抗结核药物进行六个月的化疗可治愈大多数患者，但许多患者会在治疗其他艾滋病相关并发症期间或之后死亡。
