Is HIV infection a risk factor for multi-drug resistant tuberculosis? A systematic review.
Is HIV infection a risk factor for multi-drug resistant tuberculosis? A systematic review.
复制标题
DOI：
10.1371/journal.pone.0005561
复制
发表时间：
2009
期刊：
影响因子：
3.7
通讯作者：
Van Rie A
中科院分区：
文献类型：
--
作者：
Suchindran S;Brouwer ES;Van Rie A
结核病是造成人类痛苦和死亡的一个重要原因。人类免疫缺陷病毒（HIV）、耐多药结核病（MDR-TB）和广泛耐药结核病（XDR-TB）已成为结核病控制的威胁。耐多药结核病与艾滋病毒感染之间的关系尚未得到充分调查。我们进行了一项系统回顾和荟萃分析，以总结艾滋病毒感染与耐多药结核病之间关联的证据。通过MEDLINE和ISI Web of Science对提供结核分枝杆菌耐药数据分层的原始研究进行了鉴定。按结核病类型（原发性或获得性）、地区和研究期间计算和分析耐多药结核病粗患病率。评估了各研究的异质性，并在适当的情况下生成了合并患病率。耐多药结核病与艾滋病毒感染之间没有发现跨时间和地理位置的明确关联。在32项符合条件的研究中，耐多药结核病患病率与艾滋病毒感染状况的比较从0.21到41.45不等。按地理区域或研究期间进行的评估没有显示出明显的模式。获得性和原发性耐多药结核病的总患病率分别为1.17 （95% CI 0.86, 1.6）和2.72 （95% CI 2.03, 3.66）。考虑到流行病的规模，有资格审查的研究很少。大多数研究没有对混杂因素进行调整，研究之间的异质性排除了有意义的总体总结测量的计算。我们无法证明耐多药结核病与HIV或获得性耐多药结核病与HIV之间的整体关联，但我们的研究结果表明，HIV感染与原发性耐多药结核病有关。今后需要在世界所有地区进行精心设计的研究和监测，以便更好地阐明艾滋病毒感染与耐多药结核病之间的关系。
Tuberculosis (TB) is an important cause of human suffering and death. Human immunodeficiency virus (HIV), multi-drug resistant TB (MDR-TB), and extensive drug resistant tuberculosis (XDR-TB) have emerged as threats to TB control. The association between MDR-TB and HIV infection has not yet been fully investigated. We conducted a systematic review and meta-analysis to summarize the evidence on the association between HIV infection and MDR-TB. Original studies providing Mycobacterium tuberculosis resistance data stratified by HIV status were identified using MEDLINE and ISI Web of Science. Crude MDR-TB prevalence ratios were calculated and analyzed by type of TB (primary or acquired), region and study period. Heterogeneity across studies was assessed, and pooled prevalence ratios were generated if appropriate. No clear association was found between MDR-TB and HIV infection across time and geographic locations. MDR-TB prevalence ratios in the 32 eligible studies, comparing MDR-TB prevalence by HIV status, ranged from 0.21 to 41.45. Assessment by geographical region or study period did not reveal noticeable patterns. The summary prevalence ratios for acquired and primary MDR-TB were 1.17 (95% CI 0.86, 1.6) and 2.72 (95% CI 2.03, 3.66), respectively. Studies eligible for review were few considering the size of the epidemics. Most studies were not adjusted for confounders and the heterogeneity across studies precluded the calculation of a meaningful overall summary measure. We could not demonstrate an overall association between MDR-TB and HIV or acquired MDR-TB and HIV, but our results suggest that HIV infection is associated with primary MDR-TB. Future well-designed studies and surveillance in all regions of the world are needed to better clarify the relationship between HIV infection and MDR-TB.
登录
查看更多内容
影响因子：
4.2
作者：
Conaty, SJ;Hayward, AC;Watson, JM
通讯作者：
Watson, JM
影响因子：
--
作者：
Girardi, E;Antonucci, G;Ippolito, G
通讯作者：
Ippolito, G
DOI：
10.1164/ajrccm.154.5.8912768
发表时间：
1996-11-01
影响因子：
24.7
作者：
Gordin, FM;Nelson, ET;Groom, C
通讯作者：
Groom, C
影响因子：
3.8
作者：
Joseph, P;Severe, P;Fitzgerald, DW
通讯作者：
Fitzgerald, DW
影响因子：
158.5
作者：
Espinal, MA;Laszlo, A;Raviglione, MC
通讯作者：
Raviglione, MC