Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review.

Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review.
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结核病的自然病史:艾滋病毒阴性患者未经治疗的肺结核的持续时间和死亡:系统评价。

DOI:
10.1371/journal.pone.0017601
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发表时间:
2011-04-04
期刊:
影响因子:
3.7
通讯作者:
Nagelkerke NJ
Nagelkerke NJ
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Tiemersma EW;van der Werf MJ;Borgdorff MW;Williams BG;Nagelkerke NJ

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未经治疗的结核病的预后,特别是病死率和持续时间很重要,因为许多患者没有得到正确的诊断,因此没有得到充分的治疗或治疗。此外,结核病的持续时间和病死率是解释流行病学数据的关键参数。为了估计HIV阴性患者未经治疗的肺结核的持续时间和病死率,我们回顾了化疗前的研究。艾滋病毒阴性个体中未经治疗的涂阳结核病的10年病死率报告在53%和86%之间,加权平均值为70%。10年内培养阳性痰菌阴性结核病的病死率没有直接报道,但可以间接估计约为20%。结核病从发病到治愈或死亡的持续时间约为3年,痰涂片阳性和痰涂片阴性结核病的持续时间似乎相似。目前未治疗结核病的模型假设总持续时间为2年,直到自我治愈或死亡,低估了疾病的持续时间约一年,但他们的病死率估计为70%的涂阳和20%的培养阳性涂阴结核病似乎是令人满意的。
The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epidemiological data. To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the pre-chemotherapy era. Untreated smear-positive tuberculosis among HIV negative individuals has a 10-year case fatality variously reported between 53% and 86%, with a weighted mean of 70%. Ten-year case fatality of culture-positive smear-negative tuberculosis was nowhere reported directly but can be indirectly estimated to be approximately 20%. The duration of tuberculosis from onset to cure or death is approximately 3 years and appears to be similar for smear-positive and smear-negative tuberculosis. Current models of untreated tuberculosis that assume a total duration of 2 years until self-cure or death underestimate the duration of disease by about one year, but their case fatality estimates of 70% for smear-positive and 20% for culture-positive smear-negative tuberculosis appear to be satisfactory.
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