一名HIV／TB双重感染者的HIV分离和鉴定

１９９６年８月，我们采用改良的正常人ＰＢＭＣｓ与病人ＰＢＭＣｓ共培养法，从一名ＨＩＶ／ＴＢ双重感染者的ＰＢＭＣｓ中分离出１株ＨＩＶ－１病毒，命名为ＧＤ－３。该株毒力强，在正常人ＰＢＭＣｓ中培养能引起明显的细胞病变，其ＨＩＶ－１ ｐ２４抗原滴度超过阈值，但对Ｈ９细胞不敏感。该毒株经基因序列分析为ＨＩＶ－１ Ｅ亚型，与广东省其它经性途径感染ＨＩＶ人群中的ＨＩＶ－１亚型相同。     

卧龙区全球基金TB/HIV双重感染防治项目一期效果评价

目的分析卧龙区结核病/艾滋病病毒(TB/HIV)双重感染防治项目一期(2007-2008年)的执行效果。方法对2007-2008年项目执行情况资料进行汇总分析。结果2007-2008年共确诊结核病人916例,检测HIV抗体847例,检测率92.47%;筛查HIV感染者、艾滋病病人368人、1790人次,筛查率94.36%;发现活动性结核合并艾滋病病人55例,其中新发涂阳患者3例。经抗结核治疗后,新发涂阳治愈率66.7%,症状改善病灶明显吸收37例,症状缓解率70.0%。结论卧龙区TB/HIV双重感染防治项目取得满意效果,各项指标均达到项目要求,为二期项目的实施提供了宝贵经验。     

农村地区TB/HIV双重感染状况调查

为探明固安地区结核菌/艾滋病病毒(TB/HIV)双重感染情况,自2004年１月至２006年12月,对412例肺结核病人进行了HIV感染状况调查,对53例HIV感染者进行了肺结核患病率调查.现将结果报告如下.     

HIV／TB双重感染防治

1艾滋病和结核病疫情 1．1艾滋病疫情 联合国艾滋病规划署2005年11月21日公布报告显示，2005年是自艾滋病被发现以来新增感染人数最多的一年，全世界新增艾滋病病毒感染者500万，其中超过一半人年龄在15到24岁之间，该病毒感染者总人数已达4030万。2005年全世界有310万人死于艾滋病，平均每天死亡近万人，其中57万是15岁以下的儿童。     

结核病房TB/HIV双重感染患者护理安全对策研究

目的探讨结核病房护士在护理TB/HIV双重感染患者过程中,如何有效地防止职业暴露。方法加强护士岗前培训及专业技术培训,提高护士自我防护意识和操作技能,普及正压无针连接输液、真空采血技术、改进护理工作流程可显著减少职业暴露。结果在护理105例TB/HIV双重感染患者中,无1位护士发生职业暴露。结论采取切实可行的措施是有效防止职业暴露的必要条件。     

异烟肼可降低HIV感染者的TB发病率

据医学空间网7月1日报道（原载JAMA2005，293：2710），随机研究表明，用异烟肼预防可降低HIV感染病人的结核病（TB）发病率。英国伦敦卫生学和热带医学学院Grant等指出，临床研究显示，TB预防治疗可降低HIV感染病人的TB发病率，但TB预防治疗很少实施，并且没有在日常条件下预防治疗的效果资料。     

58例TB/HIV双重感染病人流行现状分析

中国是全球结核病高负担国家之一,结核病的感染率高达44.5%,目前我国的艾滋病已经进入快速增长期,结核病（TB）和艾滋病（HIV/AIDS）已经成为我国严重的公共卫生问题和社会问题。据报道,艾滋病病毒感染者和艾滋病病人合并结核菌感染者每年有10%的人发生结核病,有50%～80%的艾滋病病人最终因结核病而死亡。新疆乌鲁木齐市水磨沟区（水区）自1996年6月报告首例艾滋病病毒感染者以来，HIV／AIDS报告病例数逐年上升，为了解水区艾滋病、     

世界卫生组织催促采取紧急措施以抗击TB和HIV

世界卫生组织(WHO)最近宣布一项规划,以扩大国家级抗击结核病(TB)和艾滋病病毒/艾滋病(HIV/AIDS)计划之间的合作,使正在全球流行的TB/HIV双重感染得以控制。这两种疾病对公共卫生是一极大的挑战,全球4 0 0 0万人已感染HIV ,而且每年增加5 0 0万新的AIDS患者。根据WHO的统计,全球人口的1/ 3已感染了TB ,其中>80 0万的病例是活动性TB ,每年死于TB的人数为2 0 0万。WHO总干事李钟郁博士说:“用有效的治疗方法,TB是可以治愈的,对HIV也有办法处理,这样,几百万的民众就可以保住他们的健康。”关键的问题是迅速扩大HIV的自愿检测…     

TB/HIV双重感染患者抗结核治疗药物不良反应分析

目的 了解TB/HIV双重感染患者抗结核治疗过程中不良反应发生频度及相关影响因素。 方法 以2007-2008年3个省共6个县,新发现TB/HIV双重感染患者为观察对象,观察这些患者抗结核治疗期间不良反应发生情况。 结果 共观察332例患者,不良反应总体发生率81.6%,其中胃肠道44.2%,肝脏13.3%,皮肤过敏反应11.4%,血液系统24.4%,神经系统18.7%,骨关节3.6%,肾、视力、耳等其他反应4.2%,68.1%不良反应发生在服用抗结核药品后30 d以内,66.8%持续时间在15 d以上,病死患者87.9%死于抗结核治疗强化期。涂阳肺结核患者、低体质量患者、静脉吸毒患者、抗病毒治疗时间较晚患者重度不良反应发生率较高。 结论 TB/HIV双重感染患者抗结核治疗不良反应发生率较单纯结核高,不良反应持续时间更长,应重视双重感染患者抗结核治疗期间不良反应监测,尤其是抗结核治疗强化期,涂阳肺结核、低体质量、静脉吸毒、抗病毒治疗时间较晚患者是重点对象。     

HIV和HCV双重感染者脂肪变性危险因素已确立

据Medscape．com7月26日报道（原载Clin Infect Dis2006；43：365-376），HIV病毒和丙型肝炎病毒（HCV）双重感染的患，常常会出现肝脂肪变性，并且与核苷类似物的使用、HCV基因型3感染和肝纤维化有关。     

结核病和结核病/艾滋病病毒双重感染的负担与挑战:尼日利亚的案例研究

目的: 了解尼日利亚结核病与结核病/艾滋病病毒(TB/HIV)双重感染的负担和结核病综合防治措施的落实情况,以确定尼日利亚结核病防控所面临的挑战,为尼日利亚消除结核病提供参考依据。方法: 利用2010—2020年世界卫生组织的全球结核病报告数据描述尼日利亚的结核病与TB/HIV双重感染负担趋势。结果: 尼日利亚是结核病与TB/HIV双重感染高负担国家,HIV感染者结核病发病率从2010年的54/10万下降至2020年的17/10万;2020年结核病确诊患者数为13.5万例,估计发病例数为45.2万,结核病治疗覆盖率仅为30%;TB/HIV双重感染患者抗逆转录病毒治疗覆盖率从2010年的6.9%增加至2020年的26.0%;结核病成功治疗率从2010年的81%提高至2019年的88%,TB/HIV双重感染患者成功治疗率从2012年的78.9%提高至2019年的81.1%;尼日利亚结核病资金总量增加,TB/HIV项目资金变化小,从2010年的450万美元增长至2020年的540万美元。结论: 尼日利亚与2020年“终止结核病战略”的目标有很大的差距。尼日利亚要减轻并消除结核病和TB/HIV双重感染负担,必须优先考虑落实结核病综合防治措施,增加必要的结核病防治资源和经费,提高结核病诊断能力。     

HIV/TB双重感染与HIV阴性结核病结核分枝杆菌耐多药现状分析

目的探讨艾滋病病毒（HIV）/结核病（TB）双重感染的结核分枝杆菌耐多药现状,为HIV/TB双重感染的耐多药结核病的防治,制定合理的预防措施及个体化的治疗方案提供科学依据。方法 2004年1月至2008年12月,在南宁市第四人民医院住院的痰结核分枝杆菌培养阳性的结核病患者,按HIV抗体检测结果分为HIV抗体阳性结核病组（HIV/TB双重感染组）和HIV抗体阴性结核病组,对两组检出的结核分枝杆菌进行菌种鉴定及耐药检测（INH、RFP、EMB、SM）,并比较两组结核分枝杆菌的总耐药和多耐药发生率,初始及获得性耐药、耐多药的发生率。结果 HIV/TB双重感染组的149株结核分枝杆菌,发生耐药的61株,总耐药率40.94%,总耐多药率为18.79%;初始耐药率为40.30%,耐多药率为18.66%;获得性耐药率为46.67%,获得性耐多药率为20.0%。HIV抗体阴性结核病组的2152株结核分枝杆菌,总耐多药、初始耐多药及获得性耐多药率分别为15.94%、8.25%、32.36%。结果显示,HIV抗体阳性组初始耐多药率较HIV抗体阴性组高,两者差异有统计学意义（P〈0.01）。结论 HIV/TB双重感染的结核分枝杆菌,对药物的耐药性流行水平有上升趋势,同时多重耐药株增多。结核分枝杆菌耐药性的监测结果 ,是指导临床治疗用药的重要依据。     

TB/HIV risk factors identified from a General Household Survey of South Africa in 2006

Abstract

The level of human immunodeficiency virus (HIV), tuberculosis (TB) as well as the co-infection TB/HIV in South Africa is among the highest in the world. TB is curable while HIV is not, yet the combination of both is a growing feature in the world. This study examined TB and HIV affecting people living in South Africa. Analyses have been undertaken based on data from the General Household Survey of South Africa in 2006. The study focused on respondents aged 15–49 years, corresponding to a total of 55,384 people composed of 25,859 males and 29,525 females. Among this population, 5935 people suffered from illness/injury, including 2469 (41.6%) males and 3466 (58.4%) females. Weighted multivariate logistic regression is performed on TB and/or HIV in association with the province, background characteristics of the target population, and selected socioeconomic and demographic variables included in the survey. In this study we focus on variables of health status and whether subjects suffered from TB and/or HIV. Findings of this investigation show that TB is the second most common cause of illness in the provinces of KwaZulu-Natal (KN) (9.1%), North West (5.4%) and Limpopo (4.2%). People who are married have a 50% lower risk compared to those currently not married to suffer from TB and/or HIV. Those with living spouses have a 5% lower risk to suffer from TB and/or HIV than those whose partners are not alive. This study concluded that rapid action is needed to curb the spread of TB and/or HIV to produce a healthy population. Therefore, follow-up care and special preventative measures are urgently needed in provinces with higher reported rates of TB and/or HIV such as KN.     

TB Since the Advent of HIV in Lesotho

ABSTRACT

A survey of patients' knowledge of and resources for combating tuberculosis (TB) since the advent of HIV in Lesotho reveals unequal access to resources and confusion of symptoms among TB, HIV/AIDS, and sejeso (an illness attributed to witchcraft). The findings suggest the need for improved health education and resource allocation.     

The emergence of extensively drug-resistant tuberculosis (TB): TB/HIV coinfection, multidrug-resistant TB and the resulting public health threat from extensively drug-resistant TB, globally and in Canada

Resistance to anti-tuberculosis (TB) drugs continues to present a major challenge to global public health. Resistance usually develops due to inadequate TB management, including improper use of medications, improper treatment regimens and failure to complete the treatment course. This may be due to an erratic supply or a lack of access to treatment, as well as to patient noncompliance. However, the emergence and transmission of drug-resistant TB, including the recently detected extensively drug resistant TB (XDR-TB), is driven, in part, by the synergistic relationship between TB and HIV (TB/HIV coinfection). There is evidence that persons infected with HIV are more likely to experience XDR-TB. XDR-TB is virtually untreatable with available TB medications. XDR-TB presents a grave global public health threat, particularly in high HIV prevalence settings. The present commentary discusses the current status of XDR-TB and draws attention to the urgency in addressing this problem, for both the global and Canadian public health networks. XDR-TB and the apparent XDR-TB and HIV association warrants further study.     

HIV／TB患者治疗过程中抗结核药物性肝损伤的临床分析

目的 判断和比较HIV阳性和阴性的结核患者抗结核药物诱导肝毒性（antituberculosis drug—induced hepatotonicity，ATDH）的临床特征。方法收集资料完整的临床病例75例HIV阳性、63例阴性的结核患者，监测ATDH的发生率和临床特征。结果 亚临床ATDH发生率为12．3％（17／138）．临床ATDH发生率为6．5％（9／138），与HIV阳性、CD4细胞计数降低、联合用药有关。结论 HIV患者免疫状态低下时，ATDH是HIV相关TB患者的一个重要问题，应常规监测肝功能和早期发现临床症状。     

Characteristics of adults and children diagnosed with tuberculosis in Lilongwe,Malawi: findings from an integrated HIV/TB clinic

Objectives To describe initial registration characteristics of adult and paediatric TB patients at a large, public, integrated TB and HIV clinic in Lilongwe, Malawi, between January 2008 and December 2010. Methods Routine data on patient with TB category and TB type, stratified by HIV and ART status, were used to explore differences in proportions among TB only, TB/HIV co‐infected patients not on ART and TB/HIV co‐infected patients on ART using chi‐square tests. Trends over time illustrate strengths and weaknesses of integrated service provision. Results Among 10 143 adults, HIV ascertainment and ART uptake were high and increased over time. The proportion of relapse was highest among those on ART (5%). The proportion of smear‐positive pulmonary TB (PTB) was highest among HIV‐negative patients with TB (34.9%); extra‐pulmonary TB (EPTB) was lowest among TB only (16.2%). Among 338 children <15 years, EPTB and smear‐positive PTB were more common among TB‐only patients. Time trends showed significant increases in the proportion of adults with smear‐positive PTB and the proportion of adults already on ART before starting TB treatment. However, some co‐infected patients still delay ART initiation. Conclusions HIV ascertainment and ART uptake among co‐infected patients are successful and improving over time. However, delays in ART initiation indicate some weakness linking TB/HIV patients into ART during TB follow‐up care. Improved TB diagnostics and screening efforts, especially for paediatric patients, may help improve quality care for co‐infected patients. These results may aid efforts to prioritise TB and HIV prevention, education and treatment campaigns for specific populations.     

Co-infection with HIV and TB: double trouble

Co-infection with HIV and Mycobacterium tuberculosis is common, particularly in the developing world. Tuberculosis (TB) is the commonest co-infection in HIV-positive individuals, who are at increased risk of both reactivation of latent infection and acquisition of new infection. As the degree of immunosuppression increases, the risks of developing TB disease also increase. The patho-physiology, clinical picture, differential diagnosis and diagnostic tests are discussed, together with the interactions between antiretroviral therapy and anti-tuberculous chemotherapy. Indications for chemoprophylaxis and vaccination against TB are reviewed.