HIVに感染した薬物使用者において,皮膚性アナーギーを有する活性結核のリスクが高い
P A Selwyn1, B M Sckell, P Alcabes
1Department of Epidemiology and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
JAMA
|July 22, 1992
まとめ
皮膚アナージーを持つHIV陽性薬物注射者は,活発な結核のリスクが高い. イソニアジドによる予防は,HIV陽性結核リエクターにおける結核病の発生率を著しく減少させた.
科学分野:
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
- 免疫学 免疫学とは
背景:
- 結核 (TB) は,特に脆弱な集団の間で,世界的な健康上の重要な懸念事項であり続けています.
- ヒト免疫不全ウイルス (HIV) 感染は,結核の再活性化および進行のリスクを大幅に高めます.
- 注射薬物使用者は,HIVと結核の両方の共感染のリスクの高いグループを表しています.
研究 の 目的:
- HIV陽性およびHIV陽性およびHIV陰性薬剤注射者において,皮膚経由で結核を発症する活性結核の発生率を決定する.
- 薬剤注射者における結核予防におけるイソニアジド化学予防の有効性を評価し,結核素検査の結果が陽性であった.
主な方法:
- ニューヨーク市のメタドンプログラムの中で,将来的な観察研究が行われました.
- 被験者は,結核素検査と多重抗原遅延型過敏性皮膚検査を受けた.
- 結核の発生率は,HIVの血清学的状態,アナージー,およびイソニアジド治療に基づいて計算されました.
主要な成果:
- HIV陽性アナージック被験者は,7.6%の活性結核の発生率を有しており,これは未治療のHIV陽性結核リエクターと比較できる割合です.
- HIV陽性の人間の活性結核の発生率は100人当たり6.6例でした.
- HIV陽性の結核リエクターで12ヶ月間,イソニアジドを予防した患者は,未治療または部分治療を受けた患者と比較して,活性結核の発生率が低下したことを示しました.
結論:
- 皮膚アナージーを持つHIV陽性薬物注射者は,活性結核のリスクが高い.
- イソニアジド化学予防法は,HIV陽性結核リエクターにおける結核の発生率を低減するのに有効である.
- HIV陽性個体に対する日常的な皮膚検査とイソニアジド予防の検討は,高感染率の環境では推奨されます.
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