HIV/AIDS病人预防和治疗结核病双重感染的研究

Research on prevention and treatment against tuberculosis in HIV/AIDS patients

目的调查HIV/AIDS病人结核菌素(PPD)试验反应状况及与免疫系统受损程度的联系,并探讨其预防和治疗结核病的意义。方法采用前瞻性病例对照研究方法,对40例HIV(+)者和202例HIV(-)者做结核菌素试验,并对HIV(十)者做CD4、CD8细胞计数测定,对HIV(+)分组服药,观察胸部病变情况。结果HIV(+)与HIV(-)者PPD阳性率分别为12.5%、28.2%(P<0.05)。当CD4细胞计数下降时,PPD反应减弱。CD4<200个/mm3时PPD均无反应(0×0).病例服药组经化学药物预防治疗后其肺部病变异常率小于病例对照组。结论HIV(+)者中PPD阳性率显著低于HIV(-)者。CD4细胞数下降可能是艾滋病并发结核的主要原因.对HIV/AIDS患者使用化学药物预防和治疗结核是有效的。

Objective Toinvestigate the association between immune response and tuberculin test and its meaning for research on prevention and treatment against tuberculosis in HIV/AIDS patients. Methods The prospective study was applied. 40 HIV(+)and 202 HIV(-) Were obserred. Tuberculin test,CD4 ?CD8 cell counts were obserred in 40 HIV(+) and 202 HIV(-).It were examined for pulmonary tuberculosis condition in therapy and control groups of HIV/AIDS. Results 12.5% HIV(+) were PPD positive,while 28.2% HIV(-) were PPD positive(P<0.05). PPD reaction decreased when CD4cell counts were decreased. PPD test of CD4 cell<200 were not positive(0×0). Pulmonary abnormal rate in therepy group was littler than abnormal rate in control group. Conclusion PPD reaction in HIV(+)was significantly lower than HIV(-).The decrease of CD4 cell might be important reason in AIDS with tubercuiosis. Chemical therapy was effective for prevention and treatment against tuberculosis in HIV/AIDS patients.