Murray J F
Department of Medicine, University of California, San Francisco, Calif., USA.
Respiration. 1998;65(5):335-42. doi: 10.1159/000029291.
The incidence of HIV-associated tuberculosis has been increasing worldwide since the beginning of the AIDS epidemic, and is expected to increase even further during the foreseeable future, especially in developing countries. There is no doubt now that, in the presence of HIV infection, new-onset tuberculous infection progresses rapidly to clinically significant disease and the likelihood that latent tuberculous infection progresses 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 Mycobacterium tuberculosis. Neither clinical features nor radiographic abnormalities reliably distinguish the majority of patients with HIV-associated tuberculosis from those without HIV infection. Some persons with HIV infection, however, present with atypical manifestations of tuberculosis and these patients may be difficult to diagnose. Six months of daily or thrice weekly chemotherapy with the usual regimen of 4 then 2 antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.
自艾滋病流行开始以来，全球范围内与艾滋病毒相关的结核病发病率一直在上升，预计在可预见的未来还会进一步增加，尤其是在发展中国家。现在毫无疑问的是，在感染艾滋病毒的情况下，新发生的结核感染会迅速发展为具有临床意义的疾病，潜伏性结核感染迅速发展为具有临床意义的疾病的可能性以及潜伏性结核感染重新激活的可能性都大大增加。艾滋病毒感染的加速和放大影响导致了耐多药结核分枝杆菌引起的疾病发病率不断上升。无论是临床特征还是影像学异常都无法可靠地区分大多数艾滋病毒相关结核病患者和未感染艾滋病毒的患者。然而，一些艾滋病毒感染者会出现非典型的结核病表现，这些患者可能难以诊断。使用通常的4种然后2种抗结核药物的方案进行为期6个月的每日或每周三次化疗可以治愈大多数患者，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。
