Domoua K, Coulibaly G, N'Dhatz M, Traore F, Kanga K, Konan J B, Beugre L K, Yapi A
Service de pneumophtisiologie, CHU de Treichville, Abidjan, Côte d'Ivoire.
Tuber Lung Dis. 1995 Dec;76(6):505-9. doi: 10.1016/0962-8479(95)90525-1.
This article reviews the main clinical aspects and progression of HIV-related tuberculosis in Abidjan. HIV prevalence in tuberculosis patients is high, estimated at 46.2% in 1992, with a clear predominance of HIV-1 over HIV-2. More than 61% of co-infected tuberculous patients meet the WHO's clinical definition of AIDS (the Bangui definition) at the time of diagnosis of tuberculosis. This rates falls to 46-51% when cough is excluded from the definition. On X-rays, the signs of pulmonary tuberculosis in co-infected tuberculous patients are atypical in the advanced stages of HIV infection, when extra-pulmonary localization, mainly mediastinal adenopathy, is frequent. Short-course chemotherapy consisting of 2 months' unsupervised daily treatment with rifampicin/isoniazid/pyrazinamide, followed by 4 months of a daily combination of rifampicin/isoniazid, applied in the Ivory Coast since 15 July 1985, has proved successful in HIV-associated tuberculosis, with treatment effectiveness rates of more than 90%.
本文综述了阿比让与艾滋病相关的结核病的主要临床情况及病情发展。结核病患者中艾滋病病毒（HIV）的流行率很高，1992年估计为46.2%，其中HIV-1明显多于HIV-2。超过61%的合并感染结核患者在结核病诊断时符合世界卫生组织（WHO）对艾滋病的临床定义（班吉定义）。若从该定义中排除咳嗽症状，这一比例降至46%-51%。在X线检查中，合并感染结核患者的肺结核征象在HIV感染晚期不典型，此时肺外定位（主要是纵隔淋巴结肿大）很常见。自1985年7月15日起在象牙海岸应用的短程化疗方案，即先进行2个月的利福平/异烟肼/吡嗪酰胺每日督导治疗，随后4个月每日联合应用利福平/异烟肼，已证明在与艾滋病相关的结核病治疗中取得成功，治疗有效率超过90%。
