浅谈HIV感染并发结核病患者的诊治问题

Discussion on the diagnosis and treatment of HIV infection complicated with tuberculosis

HIV感染并发结核病双重感染逐年上升,已经成为全球结核病防控的重要课题.由于HIV感染并发结核病患者临床表现不典型、实验室检查阳性率低、影像学表现无特异性,从而导致诊断困难,延误病情,甚至危及生命.此外,HIV感染并发结核病患者需进行抗HIV和抗MTB双重治疗,其治疗时机、药物选择、相互影响、药物不良反应等,均增加了对患者的治疗难度.这些诊治问题与单纯结核病相比存在较大不同.基于此,作者着重阐述其在发病机制、临床表现、实验室检查及治疗特点等方面的相关问题,旨在为临床诊治提供参考.

Today HIV infection complicated with tuberculosis has becoming a hot topic of global public health because of the increased incidence year by year. The diagnosis of tuberculosis （TB） in HIV-positive patients is difficult because of the atypical clinical manifestation, little laboratory positive results and nonspecifie radiographic findings, which will make patients＇ condition worse, or even life-threatening. On the other hand, patients with HIV infection complicated with tuberculosis need anti-retroviral therapy （ART） and anti-tuberculosis treatment. It＇s difficult and complex in the treatment of HIV infection complicated with tuberculosis because of drugs interaction and side effects. The diagnosis and treatment of tuberculosis in HIV-positive patients are much different from in HIV-negative patients. The review introduced the characteristics of patients with HIV infection complicated with tuberculosis in clinical manifestations, laboratory examination and therapy in order to provide more references for diagnosis and treatment of the disease.