在HIV阴性儿童中对结核病治疗的矛盾反应:系统性审查和元分析
Nabaneeta Dash1, Lovely Jain2, Meenakshi Malik2
1Department of Telemedicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
The American journal of tropical medicine and hygiene
|September 18, 2024
概括
悖论性反应 (PR) 影响了几乎每12名接受结核治疗的未感染艾滋病毒的儿童中有1名. 需要进一步的研究,以了解这种情况的风险因素和最佳管理.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 临床研究 临床研究
背景情况:
- 在结核病 (TB) 治疗期间,矛盾反应 (PR) 是一个担忧,特别是在艾滋病毒共感染的个体中.
- 艾滋病毒阴性儿童中PR的患病率和特征尚不清楚.
- 了解这一群体中的PR对于优化结核病治疗结果至关重要.
研究的目的:
- 系统地审查和估计艾滋病毒阴性儿童矛盾反应 (PR) 的负担和临床特征.
- 为了确定潜在的风险因素,管理策略和与PR相关的结果在这个人口群体中.
- 突出知识差距和进一步研究的需要.
主要方法:
- 通过使用多个数据库 (PubMed,Embase,Web of Science等) 进行了系统审查. ) 的情况.
- 包含的研究是观察性的,包括至少有5例HIV阴性儿童 (<18岁) 的PR病例的病例系列.
- 关于患病率,临床特征,风险因素,管理和结果的数据被提取并使用随机效应元分析汇总.
主要成果:
- 包括10项描述133名艾滋病毒阴性儿童的研究.
- 聚合PR的流行率估计为8.8% (95%CI:2.9%,14.6%).
- 有限的数据表明年龄较小,神经或淋巴结结核结核在患有PR的儿童中更常见;由于异质性,风险因素无法确定.
结论:
- 矛盾反应影响约8.8%的HIV阴性儿童接受结核病治疗.
- 目前的数据不足以确定特定的风险因素或最佳管理策略.
- 需要加强监测和专门研究,以更好地描述HIV阴性儿科人口中的PR.
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