Manoff S B, Farzadegan H, Muñoz A, Astemborski J A, Vlahov D, Rizzo R T, Solomon L, Graham N M
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
J Infect Dis. 1996 Aug;174(2):299-308. doi: 10.1093/infdis/174.2.299.
To examine the relationship between latent Mycobacterium tuberculosis infection and human immunodeficiency virus (HIV) disease progression, two studies were done among a cohort of HIV-infected injecting drug users. First, the decline in CD4 cell count after baseline tuberculin skin testing was prospectively compared for 37 tuberculin-positive (induration > or = 5 mm) and 284 tuberculin-negative (induration < or = 2 mm) persons. After adjustment for baseline immune function, the mean 6-month CD4 cell decline was not significantly different (34.5 vs. 45.6 cells, respectively, P = .14). Second, the plasma HIV burden at baseline skin testing was compared for 33 tuberculin-positive cases and 33 matched tuberculin-negative controls. HIV RNA was detected in 8 cases and 10 controls (odds ratio = 0.67, 95% confidence interval = 0.19-2.36). Among the 14 pairs with HIV detected in > or = 1 member, the HIV concentration was higher for the case in 4 and for the control in 10 (P = .18). These findings suggest that unlike active tuberculosis, latent M. tuberculosis infection does not hasten HIV progression.
为了研究潜伏性结核分枝杆菌感染与人类免疫缺陷病毒（HIV）疾病进展之间的关系，在一组感染HIV的注射吸毒者中开展了两项研究。首先，对37名结核菌素试验阳性（硬结≥5毫米）者和284名结核菌素试验阴性（硬结≤2毫米）者，前瞻性地比较了基线结核菌素皮肤试验后CD4细胞计数的下降情况。在对基线免疫功能进行校正后，6个月内CD4细胞平均下降数无显著差异（分别为34.5个细胞和45.6个细胞，P = 0.14）。其次，对33例结核菌素试验阳性者和33例匹配的结核菌素试验阴性对照者，比较了基线皮肤试验时的血浆HIV载量。8例病例和10例对照检测到HIV RNA（比值比 = 0.67，95%置信区间 = 0.19 - 2.36）。在≥1名成员检测到HIV的14对中，4对病例的HIV浓度较高，10对对照的HIV浓度较高（P = 0.18）。这些发现表明，与活动性结核病不同，潜伏性结核分枝杆菌感染不会加速HIV进展。
