Clinical manifestations of tuberculosis in HIV-infected patients.
Clinical manifestations of tuberculosis in HIV-infected patients.
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DOI：
10.1046/j.1440-1843.2000.00287.x
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发表时间：
2000-12-01
期刊：
影响因子：
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通讯作者：
Li, P C
中科院分区：
文献类型：
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作者：
Lee, M P;Chan, J W;Li, P C
目的：本研究的目的是评估HIV感染对结核病临床表现的影响。方法：我们回顾性研究HIV感染对肺结核临床表现的影响。共确定了60例连续合并感染艾滋病毒和结核病的患者。结果：以男性为主（88.3%），以异性接触传播为主（80%）。多数为HIV感染晚期；93%患者CD4细胞计数低于200/mm3。就结核病受累部位而言，37%仅累及肺部，13%累及单部位肺外疾病，50%同时累及肺部和肺外。15例（25%）患者也符合播散性结核的标准，其平均CD4细胞计数明显低于单纯肺部受累的患者（平均40 vs 102； P = 0.048）。胸片包括广泛的表现。相当比例的患者有原发性肺结核（38%），x线片正常（8.5%）。结论：我们的患者普遍为晚期HIV感染；93%的患者CD4淋巴细胞计数< 200/mm3。肺外受累和播散性疾病是常见的。肺结核的影像学表现通常是“不典型的”，因为我们的患者中原发性肺结核的比例更大。
OBJECTIVE: The purpose of the present study was to evaluate the impact of HIV infection on the clinical presentation of tuberculosis.METHODOLOGY: We retrospectively studied the impact of HIV infection on the clinical presentation of tuberculosis. A total of 60 consecutive patients co-infected with HIV and tuberculosis were identified.RESULTS: Majority were male (88.3%) and the most common transmission category was heterosexual contact (80%). Most were in the advanced stage of HIV infection; 93% had CD4 cell count less than 200/mm3. Concerning the site of tuberculosis involvement, 37% had pulmonary involvement alone, 13% had extrapulmonary disease involving one single site, 50% had both pulmonary and extrapulmonary involvement. Fifteen (25%) patients also met the criteria of disseminated tuberculosis, who had a significantly lower mean CD4 cell count than those with pulmonary involvement alone (mean 40 vs 102; P = 0.048). Chest radiographs comprised a wide spectrum of manifestations. A considerable proportion had primary pulmonary tuberculosis pattern (38%) and normal radiographs (8.5%).CONCLUSIONS: Our patients generally had advanced HIV infection; 93% of those had CD4 lymphocyte count < 200/mm3. Extrapulmonary involvement and disseminated disease were common. Radiographic manifestations of pulmonary tuberculosis were often 'atypical' due to the greater proportion of primary tuberculosis among our patients.