Tuberculosis Treatment Trials

结核病在许多国家仍然是一个主要问题；在撒哈拉以南非洲，在艾滋病毒/艾滋病疫情出现后，报告的病例数量急剧增加。药物敏感型结核病的治疗方案在受控试验条件下非常有效，已经存在多年，但需要至少服用6个月。许多患者未能完成治疗，因为他们在治疗2-3个月后感觉好多了。需要更短、更简单的有效方案。反恐联盟最近完成了两项国际多中心试验，评估缩短和/或简化治疗的可能性。一项评估超短波治疗的试验已经获得资金，并计划在不久的将来开始。目前迫切需要找到治疗耐多药结核病(MDR-TB)的有效方法，目前的治疗方案疗程长、毒性大、费用高，而且效果普遍较差。目前正在进行一项大型多中心试验，该试验正在评估孟加拉国开发的一种有希望的方案；该试验包括两种方案，其中含有大约50年来获得许可的第一种结核病新药。儿童结核病治疗的试验非常少，预计很快就会开始一项针对有限疾病儿童的试验，并计划进行耐药结核病和结核病脑膜炎的试验。

Tuberculosis remains a major problem in many countries; in sub-Saharan Africa numbers of cases reported have increased dramatically following the advent of the HIV-AIDS epidemic. Treatment regimens for drug-sensitive tuberculosis which are highly effective under controlled trial conditions have been available for many years but need to be given for at least 6 months. Many patients fail to complete treatment since they feel much better after 2-3 months treatment. Shorter and simpler effective regimens are needed. The CTU recently completed two international multi-centre trials assessing the possibility of treatment shortening and/or simplifying treatment. A trial assessing ultra-short treatment has been funded and is planned to commence in the near future. There is an urgent need to find effective treatments for multi-drug resistant tuberculosis (MDR-TB), current regimens are given for long durations, are toxic, expensive and results are generally poor. A large multi-centre trial is currently in progress which is assessing a promising regimen which has been developed in Bangladesh; the trial includes two regimens containing the first new tuberculosis drug to be licensed for about 50 years. There have been very few trials of tuberculosis treatment in children, one such trial in children with limited disease is expected to start soon and trials in drug-resistant tuberculosis and TB-meningitis are planned.