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HIV感染/AIDS合并结核病的临床研究进展
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Abstract:
世界范围内人获得性免疫缺陷病毒(HIV)感染/获得性免疫缺陷综合征(AIDS)合并结核病(TB)的发病率和检出率不断升高，HIV可诱导机体炎性因子分泌和体细胞免疫功能缺陷的增加，从而增加患者感染结核分枝杆菌(Mycobacterium tuberculosis，MTB)的风险。而感染MTB可上调共受体CCR5和CXCR4的表达，从而促进HIV病毒感染巨噬细胞和T细胞。HIV感染/AIDS合并TB患者的结核症状于免疫功能有关，同时以Gene Xpert MTB/RIF为代表的新型分子生物学技术也具有良好的病原学诊断价值。目前，科学规范的临床治疗、管理仍是HIV感染/AIDS合并TB首选的防控策略。因此，本文对HIV感染/AIDS合并TB的流行病学、发病机制、临床表现及诊治等方面进行综述，以期为HIV感染/AIDS合并TB的临床防控提供一定的参考依据。
The incidence and detection rate of human acquired immunodeficiency virus (HIV) infec-tion/acquired immunodeficiency syndrome (AIDS) combined with tuberculosis (TB) are increasing worldwide. HIV can induce the secretion of inflammatory factors and the increase of somatic im-mune dysfunction. That increases the risk of contracting Mycobacterium tuberculosis (MTB). How-ever, infection with MTB can up-regulate the expression of co-receptors CCR5 and CXCR4, thus pro-moting HIV infection of macrophages and T cells. The tuberculosis symptoms of HIV infection/AIDS patients with TB are related to immune function. Meanwhile, the novel molecular biological tech-nology represented by Gene Xpert MTB/RIF also has good value in etiological diagnosis. At present, scientific and standardized clinical treatment and management are still the preferred prevention and control strategies for HIV infection/AIDS complicated with TB. Therefore, this paper reviews the epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment of HIV infec-tion/AIDS complicated with TB, in order to provide certain reference for the clinical prevention and control of HIV infection/AIDS complicated with TB.
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