与艾滋病毒相关的耐药结核病:扩大治疗选择和新出现的威胁
Miriam Abadie1,2, Alexander Kay1,2
1Baylor College of Medicine, Houston, Texas, USA.
Current opinion in HIV and AIDS
|December 29, 2025
概括
对于艾滋病毒 (PWH) 感染者的耐药结核病 (DR-TB) 治疗的进展包括更短的口服疗法. 仔细管理药物相互作用和新疗法对于改善与艾滋病毒相关的DR-TB的治疗结果至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病研究研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 耐药结核病 (DR-TB) 是一个重大挑战,特别是在艾滋病毒感染者 (PWH) 中.
- 在PWH中管理DR-TB需要仔细考虑药物相互作用和并发性疾病.
- 耐药结核病的治疗环境一直在发展.
研究的目的:
- 总结一下近期DR-TB治疗PWH的进展情况.
- 审查药物相互作用,试验药物和宿主导疗法.
- 讨论有关新疗法,结核病后并发症和耐药性模式的新兴证据.
主要方法:
- 审查最近的临床试验和关于在PWH治疗DR-TB的科学文献.
- 对抗结核病和抗逆转录病毒疗法 (ART) 之间的药物相互作用数据的分析.
- 评估试验性结核病药物和宿主导治疗方法.
主要成果:
- 较短,全口服的DR-TB疗法,药物相互作用减少,正在变得可用.
- 新兴的杜洛特格拉维尔耐药性可能需要复杂的ART疗法,使DR-TB管理复杂化.
- 试验性结核病药物 (BTZ-043,sutezolid,delpazolid) 是有前途的;然而,成功的缩短疗程往往含有贝达奎林,这带来了新兴贝达奎林耐药性的挑战.
- 目前正在探索宿主导疗法,以治疗和预防诸如免疫复合炎症综合征和后结核肺病等并发症.
结论:
- 耐药性结核病的治疗选择有了显著的改善,提供了更少的毒性和更有效的治疗方案.
- 管理与艾滋病毒相关的耐药结核病需要对药物相互作用和与艾滋病毒相关的并发症给予细致的关注.
- 持续研究新型的DR-TB疗法,特别是针对贝达基林耐药病例,以及宿主导疗法,对于改善结果至关重要.
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