EXTRAPULMONARY AND DISSEMINATED TUBERCULOSIS IN HIV-1-SEROPOSITIVE PATIENTS PRESENTING TO THE ACUTE MEDICAL-SERVICES IN NAIROBI

EXTRAPULMONARY AND DISSEMINATED TUBERCULOSIS IN HIV-1-SEROPOSITIVE PATIENTS PRESENTING TO THE ACUTE MEDICAL-SERVICES IN NAIROBI
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DOI：
10.1097/00002030-199010000-00006
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发表时间：
1990-10-01
期刊：
AIDS
影响因子：
3.8
通讯作者：
WARRELL, DA
WARRELL, DA
中科院分区：
医学2区
文献类型：
--
作者：
GILKS, CF;BRINDLE, RJ;WARRELL, DA

文献摘要

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我们研究了内罗毕连续506例成人急性医疗入院; 95例（18.8%）HIV-1血清阳性，并确定了43例新的活动性结核病（TB）病例。TB与HIV感染明显相关，血清阳性患者中发生率为17.9%，血清阴性患者中发生率为6.3%[比值比（OR）3.2; 95%置信限（CL）1.6-6.5]。肺外疾病在血清阳性患者中比血清阴性患者更常见（17例中有9例，26例中有5例; OR 4.7; 95%CL 1.01-23.6）;这是血清阳性患者中观察到的大多数结核病例的原因。8例血清学阳性结核病患者中有2例出现分枝杆菌血症，但11例血清学阴性结核病患者中无一例出现分枝杆菌血症。未分离出非典型分枝杆菌。世界卫生组织（世卫组织）对非洲艾滋病的临床病例定义没有很好地区分血清阳性和血清阴性结核病病例。7名血清反应阳性的活动性结核病妇女中有5名在过去6个月内分娩并处于哺乳期，而8名血清反应阴性的结核病妇女中只有1名分娩并处于哺乳期。最近分娩，艾滋病毒免疫抑制和结核病的发展之间的关联建议。
We studied 506 consecutive adult acute medical admissions to hospital in Nairobi; 95 (18.8%) were seropositive for HIV-1, and 43 new cases of active tuberculosis (TB) were identified. TB was clearly associated with HIV infection, occurring in 17.9% of seropositive patients compared with 6.3% of seronegatives [odds ratio (OR) 3.2; 95% confidence limits (CL) 1.6-6.5]. Extrapulmonary disease was more common in seropositive than seronegative TB patients (nine out of 17 versus five out of 26; OR 4.7; 95% CL 1.01-23.6); this accounted for most of the excess cases of TB seen in seropositive patients. Mycobacteraemia was demonstrated in two of eight seropositive TB patients but in none of 11 seronegative TB patients. No atypical mycobacteria were isolated. The World Health Organization (WHO) clinical case definition for African AIDS did not discriminate well between seropositive and seronegative TB cases. Five out of seven seropositive women with active tuberculosis had delivered children in the preceding 6 months and were lactating, compared with only one out of eight seronegative tuberculous women. As association between recent childbirth, HIV immunosuppression and the development of TB is suggested.