Ortona L, Antinori A
Istituto di Clinica delle Malattie Infettive, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy.
Rays. 1998 Jan-Mar;23(1):78-86.
The close connection between tuberculosis and HIV infection was evident since the onset of the epidemic. The spread of HIV has contributed to the increased incidence of tuberculosis world-wide. With the progressively impaired cell-mediated immunity, HIV alters the pathogenesis of tuberculosis and markedly increases the risk of tuberculosis in simultaneously infected subjects. An altered pathogenesis of tuberculosis leads to a more frequent extrapulmonary involvement and atypical radiologic findings. Furthermore, HIV infection is one of the major factors of increased risk of M. tuberculosis multidrug resistance. Even if tuberculosis in HIV-positive patients to some extent can be treated and prevented, it spread in this population is increasing and at present tuberculosis represents the most common opportunistic HIV-related infection several areas world-wide and globally, the first cause of death of HIV-infected patients.
自艾滋病流行开始以来，结核病与艾滋病毒感染之间的密切联系就很明显。艾滋病毒的传播导致全球结核病发病率上升。随着细胞介导免疫功能逐渐受损，艾滋病毒改变了结核病的发病机制，并显著增加了同时感染艾滋病毒的患者患结核病的风险。结核病发病机制的改变导致肺外受累更为频繁，影像学表现也不典型。此外，艾滋病毒感染是结核分枝杆菌多重耐药风险增加的主要因素之一。即使艾滋病毒阳性患者的结核病在一定程度上可以得到治疗和预防，但其在这一人群中的传播仍在增加，目前结核病是全球多个地区最常见的与艾滋病毒相关的机会性感染，也是艾滋病毒感染患者的首要死因。
