Clinical course of human immunodeficiency virus type 1 associated pulmonary tuberculosis during short-course antituberculosis therapy.
Clinical course of human immunodeficiency virus type 1 associated pulmonary tuberculosis during short-course antituberculosis therapy.
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短期抗结核治疗期间人类免疫缺陷病毒 1 型相关肺结核的临床过程。
DOI：
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发表时间：
1997
影响因子：
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通讯作者：
Christopher C. Whalen
中科院分区：
文献类型：
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作者：
S. Schwander;S. Schwander;M. Dietrich;PETER N. Mugyenyi;C. Kityo;A. Okwera;John L. Johnson;P. Nsubuga;S. Ruesch;Christopher C. Whalen
为了描述HIV-1疾病对抗结核治疗的临床反应，对49名HIV-1阳性的乌干达成年人(平均年龄29.4岁，其中68%为男性)进行了含有短程抗结核方案的利福平试验。发病时18例为PPD非反应性病变(PPD皮试硬结直径2 mm)，10例(20%)为非空洞性肺疾病。初诊时平均CD4淋巴细胞计数为339个/微升(+/-SD 275)。在基线临床值异常的患者中，发热消退、体重增加10%、血红蛋白升至10g/dl和卡氏评分(KPS)升至80的中位时间出现在痰涂片和培养转换之前。短期存活率与基线淋巴细胞1200/微升(优势比(OR)17.5)、CD4+淋巴细胞200/微升(OR 9.8)、空洞性肺疾病(OR 0.6)、不典型胸片(OR 6.7)和PPD无反应(OR 13.5)、PPD无反应性和非空洞性疾病相关。负担得起的系列测量与治疗反应平行，并预测HIV相关肺结核患者的存活率。
To describe the clinical response to antituberculosis therapy in HIV-1 disease, 49 HIV-1 positive Ugandan adults (mean age 29.4 years; 68% men) with active pulmonary tuberculosis (PTB) were studied in a trial of rifampicin containing short-course antituberculosisis regimens. At presentation, 18 patients were PPD non-reactors (PPD skin test induration < 2mm), ten patients (20%) had non-cavitary lung disease. The mean CD4 lymphocyte count at presentation was 339/microliters (+/- SD 275). Among patients with abnormal baseline clinical values, the median time to resolution of fever, weight gain of 10%, increase of haemoglobin to 10g/dl and of Karnofsky performance score (KPS) to 80 occurred before sputum smear and culture conversion. Short-term survival was associated with: baseline lymphocytes < 1200/microliters, (Odds ratio (OR) 17.5), CD4+ lymphocytes < 200/microliters (OR 9.8), cavitary lung disease, (OR 0.6), atypical chest radiograph, (OR 6.7), and PPD non-reactivity, (OR 13.5), PPD non-reactivity and non-cavitary disease were associated with significantly lower CD4 lymphocyte counts. Affordable serial measurements parallel the response to therapy and predict survival in HIV-associated PTB.