HIV/AIDS并发亚临床结核病现状研究进展

doi:10.19982/j.issn.1000-6621.20230459

摘要/Abstract

摘要：

人类免疫缺陷病毒(human immunodeficiency virus,HIV)与结核分枝杆菌(Mycobacterium tuberculosis,MTB)双重感染一直是全球公共卫生关注的问题,也是临床诊疗工作的重点和挑战。随着人们对于结核病的认识不断完善,人们逐渐认识到亚临床结核病(subclinical tuberculosis,STB)在疾病谱中的重要性。笔者详细探讨了HIV/AIDS并发STB的流行现状、临床特征、筛检与诊断、治疗和预防等方面问题,旨在引起公共卫生和临床从业者的高度关注,鼓励进一步开展深入研究,提高对HIV/AIDS并发STB患者的重视,为制定降低HIV/AIDS与STB共病的措施提供科学依据。

关键词: 结核, HIV感染, 获得性免疫缺陷综合征, 共病现象

Abstract:

Human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) co-infection has always been a global public health concern, as well as a key point and challenge in clinical diagnosis and treatment. The importance of subclinical tuberculosis (STB) in the disease spectrum has been gradually realized as we improve the awareness of tuberculosis. The authors discussed in detail the prevalence, clinical characteristics, screening and diagnosis, treatment and prevention of STB in HIV-Infected patients and AIDS patients, aiming to draw concern from public health and clinical practitioners, encourage further in-depth researches and more attention on STB in HIV/AIDS population,so as to provide scientific basis for developing strategies to reduce the comorbidity of HIV/AIDS and STB.

Key words: Tuberculosis, HIV infections, Acquired immune deficiency syndrom, Comorbidity

中图分类号:

R521
R18

刘美君, 李锋. HIV/AIDS并发亚临床结核病现状研究进展[J]. 中国防痨杂志, 2024, 46(5): 596-600. doi: 10.19982/j.issn.1000-6621.20230459

Liu Meijun, Li Feng. Current situation and research progress of co-infection of HIV/AIDS and subclinical tuberculosis[J]. Chinese Journal of Antituberculosis, 2024, 46(5): 596-600. doi: 10.19982/j.issn.1000-6621.20230459

参考文献 33

[1]	Jesudason T. Global progress reported for AIDS. Lancet Infect Dis, 2023, 23(9): e342. doi:10.1016/S1473-3099(22)00684-3. pmid: 37633298
[2]	何纳. 中国艾滋病流行病学研究新进展. 中华疾病控制杂志, 2021, 25(12): 1365-1368,1480. doi:10.16462/j.cnki.zhjbkz.2021.12.001.
[3]	李蒙, 高谦. 结核病自然史的阶段划分及其诊断的现状与展望. 中国防痨杂志, 2021, 43(11): 1125-1131. doi:10.3969/j.issn.1000-6621.2021.11.005.
[4]	Migliori GB, Ong CWM, Petrone L, et al. The definition of tuberculosis infection based on the spectrum of tuberculosis disease. Breathe (Sheffield, England), 2021, 17(3): 210079. doi:10.1183/20734735.0079-2021.
[5]	舒薇, 刘宇红. 世界卫生组织《2023年全球结核病报告》解读. 结核与肺部疾病杂志, 2024, 5(1): 15-19. doi:10.19983/j.issn.2096-8493.2024004.
[6]	王涵飞, 李涛, 赵雁林, 等. 2021—2022年全国亚临床结核病治疗转归及其影响因素分析. 热带病与寄生虫学, 2023, 21(2): 72-77,92.
[7]	Naidoo K, Moodley MC, Hassan-Moosa R, et al. Recurrent Subclinical Tuberculosis Among Antiretroviral Therapy-Accessing Participants: Incidence, Clinical Course, and Outcomes. Clin Infect Dis, 2022, 75(9): 1628-1636. doi:10.1093/cid/ciac185.
[8]	Kendall EA, Shrestha S, Dowdy DW. The Epidemiological Importance of Subclinical Tuberculosis. A Critical Reappraisal. Am J Respir Crit Care Med, 2021, 203(2): 168-174. doi:10.1164/rccm.202006-2394PP.
[9]	Onozaki I, Law I, Sismanidis C, et al. National tuberculosis prevalence surveys in Asia, 1990—2012: an overview of results and lessons learned. Trop Med Int Health, 2015, 20(9): 1128-1145. doi:10.1111/tmi.12534. pmid: 25943163
[10]	Bajema KL, Bassett IV, Coleman SM, et al. Subclinical tuberculosis among adults with HIV: clinical features and outcomes in a South African cohort. BMC Infect Dis, 2019, 19(1): 14. doi:10.1186/s12879-018-3614-7. pmid: 30611192
[11]	Oni T, Burke R, Tsekela R, et al. High prevalence of subclinical tuberculosis in HIV-1-infected persons without advanced immunodeficiency: implications for TB screening. Thorax, 2011, 66(8): 669-673. doi:10.1136/thx.2011.160168. pmid: 21632522
[12]	Rickman HM, Cohn S, Lala SG, et al. Subclinical tuberculosis and adverse infant outcomes in pregnant women with HIV. Int J Tuberc Lung Dis, 2020, 24(7): 681-685. doi:10.5588/ijtld.19.0500.
[13]	Foster N, Nguyen HV, Nguyen NV, et al. Social determinants of the changing tuberculosis prevalence in Viêt Nam: Analysis of population-level cross-sectional studies. PLoS Med, 2022, 19(3): e1003935. doi:10.1371/journal.pmed.1003935.
[14]	Gunasekera K, Cohen T, Gao W, et al. Smoking and HIV associated with subclinical tuberculosis: analysis of a population-based prevalence survey. Int J Tuberc Lung Dis, 2020, 24(3): 340-346. doi:10.5588/ijtld.19.0387. pmid: 32228765
[15]	Gong W, Wu X. Differential Diagnosis of Latent Tuberculosis Infection and Active Tuberculosis: A Key to a Successful Tuberculosis Control Strategy. Front Microbiol, 2021, 12: 745592. doi:10.3389/fmicb.2021.745592.
[16]	van’t Hoog AH, Laserson KF, Githui WA, et al. High pre-valence of pulmonary tuberculosis and inadequate case finding in rural western Kenya. Am J Resp Crit Care Med, 2011, 183(9): 1245-1253. doi:10.1164/rccm.201008-1269OC.
[17]	Manabe YC, Breen R, Perti T, et al. Unmasked tuberculosis and tuberculosis immune reconstitution inflammatory disease: a disease spectrum after initiation of antiretroviral therapy. J Infect Dis, 2009, 199(3): 437-444. doi:10.1086/595985. pmid: 19090776
[18]	Organization WH. Definitions and Reporting Framework for Tuberculosis—2013 Revision. Geneva: World Health Organization, 2013. doi:10.1007/BF00453658.
[19]	Di Tanna GL, Khaki AR, Theron G, et al. Effect of Xpert MTB/RIF on clinical outcomes in routine care settings: individual patient data meta-analysis. Lancet Glob Health, 2019, 7(2): e191-e199. doi:10.1016/S2214-109X(18)30458-3.
[20]	Esmail A, Tomasicchio M, Meldau R, et al. Comparison of Xpert MTB/RIF (G4) and Xpert Ultra, including trace readouts, for the diagnosis of pulmonary tuberculosis in a TB and HIV endemic setting. Int J Infect Dis, 2020, 95: 246-252. doi:10.1016/j.ijid.2020.03.025. pmid: 32247825
[21]	World Health Organization. High priority target product profiles for new tuberculosis diagnostics: report of a consensus meeting, 28-29 April 2014. Geneva: World Health Organization, 2014.
[22]	Ngangue YR, Mbuli C, Neh A, et al. Diagnostic Accuracy of the Truenat MTB Plus Assay and Comparison with the Xpert MTB/RIF Assay to Detect Tuberculosis among Hospital Outpatients in Cameroon. J Clin Micro, 2022, 60(8): e0015522. doi:10.1128/jcm.00155-22.
[23]	Bjerrum S, Broger T, Székely R, et al. Diagnostic Accuracy of a Novel and Rapid Lipoarabinomannan Test for Diagnosing Tuberculosis Among People With Human Immunodeficiency Virus. Open Forum Infect Dis, 2020, 7(1): ofz530. doi:10.1093/ofid/ofz530.
[24]	World Health Organization. WHO consolidated guidelines on tuberculosis. Module 3: diagnosis-rapid diagnostics for tuberculosis detection. Geneva:World Health Organization, 2020.
[25]	Broger T, Sossen B, du Toit E, et al. Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study. Lancet Infect Dis, 2019, 19(8): 852-861. doi:10.1016/S1473-3099(19)30001-5. pmid: 31155318
[26]	Nathavitharana RR, Garcia-Basteiro AL, Ruhwald M, et al. Reimagining the status quo: How close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine, 2022, 78: 103939. doi:10.1016/j.ebiom.2022.103939.
[27]	World Health Organization. Rapid communication on systematic screening for tuberculosis. Geneva: World Health Organization, 2020.
[28]	Patterson B, Bryden W, Call C, et al. Cough-independent production of viable Mycobacterium tuberculosis in bioaerosol. Tuberculosis (Edinburgh, Scotland), 2021, 126: 102038. doi:10.1016/j.tube.2020.102038.
[29]	Williams CML, Cheah ESG, Malkin J, et al. Face mask sampling for the detection of Mycobacterium tuberculosis in expelled aerosols. PLoS One, 2014, 9(8): e104921. doi:10.1371/journal.pone.0104921.
[30]	Williams CM, Abdulwhhab M, Birring SS, et al. Exhaled Mycobacterium tuberculosis output and detection of subclinical disease by face-mask sampling: prospective observational studies. Lancet Infect Dis, 2020, 20(5): 607-617. doi:10.1016/S1473-3099(19)30707-8.
[31]	Gatechompol S, Sophonphan J, Kerr SJ, et al. Monocyte-to-lymphocyte ratio as a predictor of TB among people living with HIV. Int J Tuberc Lung Dis, 2021, 25(11): 933-938. doi:10.5588/ijtld.21.0300.
[32]	Penn-Nicholson A, Mbandi SK, Thompson E, et al. RISK6, a 6-gene transcriptomic signature of TB disease risk, diagnosis and treatment response. Sci Rep, 2020, 10(1): 8629. doi:10.1038/s41598-020-65043-8. pmid: 32451443
[33]	Gupta RK, Lucas SB, Fielding KL, et al. Prevalence of tuberculosis in post-mortem studies of HIV-infected adults and children in resource-limited settings: a systematic review and meta-analysis. AIDS (London, England), 2015, 29(15): 1987-2002. doi:10.1097/QAD.0000000000000802.