艾滋病病毒感染促使结核菌潜伏感染患者因近期再次感染结核菌而发生结核病的风险增加
Human immunodeficiency virus increases the risk of tuberculosis due to recent re-infection in individuals with latent infection
摘要
背景:艾滋病病毒(HIV)感染会导致结核分枝杆菌潜伏感染的复燃或近期(再次)感染结核分枝杆菌后发展成为活动性结核病。尽管发病既往有结核分枝杆菌潜伏感染的证据,但如果发生在同一时期的结核病患者的结核分枝杆菌菌株相同(例如"组群病例"),则本次发病很可能是由于近期(再次)感染结核分枝杆菌所致。方法:在马拉维北部卡朗加区1996年至2008年间曾第一次患结核病的患者中,若其具有1990年之前结核分枝杆菌潜伏感染状态(结核分枝杆菌素皮肤试验)的信息和结核病发病时的DNA指纹结果,则纳入本研究。我们对既往结核分枝杆菌潜伏感染状况和HIV感染状况进行分组,探讨组间的差异,并依据年龄、性别、卡介苗疤痕状况和距结核分枝杆菌素检测的时间作了调整。结果:在79例HIV阴性的结核病患者中,有结核分枝杆菌潜伏感染史的患者比无结核分枝杆菌潜伏感染史的患者更少发生组群病例(29比77%,调整OR=0.15,95%可信区间为0.04～0.59)。在119个HIV阳性结核病患者中,两组的组群病例所占比例相似(88%比84%,调整OR=1.85,95%可信区间为0.41～8.29)。讨论:HIV感染似乎增加了新近再次感染结核分枝杆菌而发展成为结核病的风险。越来越多证据表明HIV相关结核病主要源于新近结核分枝杆菌感染,我们的研究结果也证实了这一点。
出处
《国际结核病与肺部疾病杂志》
2011年第3期134-140,共7页
The International Journal of Tuberculosis and Lung Disease
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