Epidemiology of HIV-associated tuberculosis.
Epidemiology of HIV-associated tuberculosis.
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DOI：
10.1097/coh.0b013e32832c7d61
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发表时间：
2009-07
影响因子：
4.1
通讯作者：
Churchyard G
中科院分区：
文献类型：
--
作者：
Lawn SD;Churchyard G
我们回顾了有关艾滋病毒相关结核病（HIV-TB）流行病学的文献，重点是2007-2008年间发表的文章。据估计，2007年发生了137万例艾滋病毒结核病新病例，占全球结核病总负担的15%。此外，估计有456，000例艾滋病毒-结核病死亡，占全球艾滋病毒/艾滋病死亡率的23%。撒哈拉以南非洲是受影响最严重的地区，占疾病负担的79%。这一共同流行病的震中位于非洲大陆南部，仅南非就占所有病例的四分之一以上。艾滋病毒和全球耐多药结核病流行之间的关键重叠正在出现。尽管目前尚不清楚艾滋病毒是否在人口水平上导致耐多药结核病例不成比例地增加，但艾滋病毒已成为机构性疫情的一个潜在风险因素，特别是在南非和东欧。越来越多的数据突出表明，在资源有限的环境中，感染艾滋病毒的卫生保健工作者有患结核病的风险。然而，许多研究也表明，抗逆转录病毒疗法在高收入和低收入国家都能带来重大惠益。艾滋病毒/结核病仍然是全球卫生的一个重大挑战，需要大幅度增加资源分配和采取协调一致的国际行动。
We review literature concerning the epidemiology of HIV-associated tuberculosis (HIV-TB), focussing on articles published between 2007-2008. An estimated 1.37 million new cases of HIV-TB occurred in 2007, representing 15% of the total global burden of TB. In addition, an estimated 456,000 HIV-TB deaths accounted for 23% of global HIV/AIDS mortality. Sub-Saharan Africa is the worst affected region with 79% of the disease burden. The epicentre of the co-epidemic lies in the south of the continent, with South Africa alone accounting for over one quarter of all cases. A critical overlap between HIV and the global multi-drug resistant TB (MDR-TB) epidemics is emerging. Although it is as yet unclear whether HIV is driving a disproportionate increase in MDR-TB cases at a population level, HIV has nevertheless been a potent risk factor for institutional outbreaks, especially in South Africa and Eastern Europe. Increasing data have highlighted the risk of TB among HIV-infected health-care workers in resource-limited settings. However, many studies also show the major benefits to be derived from antiretroviral therapy in high- and low-income countries. HIV-TB remains a major challenge to global health that requires substantial increases in resource allocation and concerted international action.