When do co-infections matter?
When do co-infections matter?
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DOI：
10.1097/qco.0000000000000447
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发表时间：
2018-06
影响因子：
3.9
通讯作者：
Cunnington AJ
中科院分区：
文献类型：
--
作者：
McArdle AJ;Turkova A;Cunnington AJ
诊断方法的进步意味着在临床实践中越来越多地检测到合并感染，但其意义并不总是明显的。与此同时，基础科学研究越来越多地调查病原体之间的相互作用，试图解释现实生活中的观察结果并阐明生物机制。合并感染可能是微不足道的，有害的，甚至是有益的，这些结果可以通过多个水平的相互作用发生，包括调节宿主反应，改变诊断测试的性能，以及治疗期间的药物相互作用。慢性合并感染如结核病或与艾滋病毒相关的B和C型肝炎的有害影响已得到充分证实，最近的研究集中在减轻这些影响的战略上。然而，许多急性合并感染的后果是不太确定的，最近相互矛盾的发现只是强调了研究人类自然获得性感染的许多挑战。应对这些挑战，使用动物模型或在人类中进行仔细的前瞻性研究可能是值得的。已经有一些诱人的例子表明，识别和治疗相关的合并感染似乎有望改善健康结果。
Advances in diagnostic methods mean that co-infections are increasingly being detected in clinical practice, yet their significance is not always obvious. In parallel, basic science studies are increasingly investigating interactions between pathogens to try to explain real-life observations and elucidate biological mechanisms. Co-infections may be insignificant, detrimental, or even beneficial, and these outcomes can occur through multiple levels of interactions which include modulation of the host response, altering the performance of diagnostic tests, and drug–drug interactions during treatment. The harmful effects of chronic co-infections such as tuberculosis or Hepatitis B and C in association with HIV are well established, and recent studies have focussed on strategies to mitigate these effects. However, consequences of many acute co-infections are much less certain, and recent conflicting findings simply highlight many of the challenges of studying naturally acquired infections in humans. Tackling these challenges, using animal models, or careful prospective studies in humans may prove to be worthwhile. There are already tantalizing examples where identification and treatment of relevant co-infections seems to hold promise for improved health outcomes.