艾滋病合并结核病诊治中的关键问题

Key issues of diagnosis and treatment of acquired immunodeficiency syndrome complicated with tuberculosis

结核病是HIV感染/AIDS患者常见的机会性感染和疾病进展的重要因素,也是这类患者死亡的主要原因之一。随着人们对两病认识的深入,以及相关临床研究证据的积累,人们对AIDS合并结核病诊治中的一些问题越来越关注。现笔者结合《2022年艾滋病合并结核病的国内专家共识》以及相关的临床实践对这类特殊人群的筛查方向、新型诊断技术的运用、短程抗结核治疗的疗效、抗病毒药物的选择与时机、整合酶抑制剂与利福霉素类药物间的相互作用,以及结核相关免疫重建炎症反应综合征的识别和处理等几个关键问题进行阐述。

Tuberculosis is a common opportunistic infection and an important factor in disease progression in patients with human immunodeficiency virus(HIV)infection/acquired immunodeficiency syndrome(AIDS),and is also one of the main causes of death in HIV infection/AIDS patients.With the deepening of understanding of the two diseases and the accumulation of relevant clinical research evidence,people pay more and more attention to some problems in the diagnosis and treatment of AIDS combined with tuberculosis.In combination with the consensus of domestic experts on AIDS complicated with tuberculosis in 2022 and clinical practice,the author reviewed several key issues such as the screening direction of this special group,the application of new diagnostic techniques,the efficacy of short-term anti-tuberculosis regimen,the selection and timing of antiviral drugs,the interaction between integrase inhibitors and rifamycin,and the identification and treatment of tuberculosis related immune reconstitution inflammatory response syndrome.