结核病和艾滋病毒共感染:减少发病率和死亡率的进展和挑战
Bianca Sossen1, Mmamapudi Kubjane2, Graeme Meintjes3
1Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa.
概括
与艾滋病毒相关的结核病 (HIV-TB) 显著增加死亡率. 预防,诊断和治疗方面的最新进展改善了生存率,但对于最佳的艾滋病毒-结核病管理仍然存在知识差距.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 免疫学 免疫学 免疫学
背景情况:
- 与艾滋病毒相关的结核病 (HIV-TB) 导致不成比例的高死亡率,在2023年,24%的同时感染的人死亡.
- 艾滋病毒在全球推动结核病发病率,特别是在世卫组织非洲地区,结核病是艾滋病毒感染者 (PWH) 入院的主要原因.
研究的目的:
- 审查最近在预防,查,诊断和艾滋病毒-结核病管理方面的进展.
- 确定和讨论正在进行的知识差距和未来的HIV-TB研究方向.
主要方法:
- 对抗逆转录病毒疗法和结核病预防疗法的最新发展进行审查.
- 对Xpert Ultra和尿液等诊断工具的评估 确定结核病LAM抗原,以改善生存率.
- 讨论疫苗开发的当前研究,新的治疗策略和结核病耐药性的诊断方法.
主要成果:
- 抗逆转录病毒疗法和新的结核病预防疗法降低了结核病发病率,提高了PWH患者的生存率.
- 像Xpert Ultra和尿液确定结核病LAM抗原这样的先进诊断方法与更好的HIV-TB生存结果有关.
- 尽管取得了进展,但在了解结核病自然史,最佳诊断 (包括非吐样本) 和PWH的结核病后护理方面仍然存在差距.
结论:
- 在治疗艾滋病毒-结核病方面取得了重大进展,新的治疗方法和诊断方法改善了结果.
- 解决结核病自然史,诊断和结核病后护理方面的知识差距对于减少艾滋病毒-结核病发病率和死亡率至关重要.
- 目前正在进行的疫苗,治疗和诊断研究有望进一步推进艾滋病毒-结核病管理.
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