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Disseminated Mycobacterium avium on HIV/AIDS: Historical and Current Literature Review.
AIDS Reviews ( IF 2.2 ) Pub Date : 2020-3-14 , DOI: 10.24875/aidsrev.20000104
João P. Marochi-Telles , Jaques Sztajnbok , Roberto Muniz Jr. , Andre Cosme-de Oliveira

Combination antiretroviral therapy (cART) has changed Mycobacterium avium epidemiology. A significant decrease in the incidence of disseminated M. avium complex: (DMAC) infection was observed between pre-cART and post-cART periods. In contrast, diagnoses of DMAC more than doubled from 1990 to 1996. During this time, DMAC prevalence in people living with AIDS (PLHA) in developed countries reached 20-23% overall and >40% in groups with CD4 cell counts <10 cells/mm3. At present, DMAC in PLHA has an incidence of two events per 1000 patient years. Recently, the centers for disease control changed the criteria for MAC primary prophylaxis, where only patients without immediate cART and CD4 cell counts <50 cells/mm3 are prescribed 1200 mg of azithromycin weekly. Treatment is discontinued when patients initiate effective cART. Diagnosing a disseminated M. avium infection is difficult due to the low accuracy of fluid cultures and a lack of diagnostic processes. However, the usefulness of newer molecular techniques such as whole-genome sequencing has not been evaluated for DMAC and HIV/AIDS. As DMAC has a high mortality rate if not properly diagnosed and treated, we performed a literature review of HIV/AIDS and DMAC epidemiology, risk factors, prophylaxis, clinical manifestation, diagnosis, prognosis, and treatment.

中文翻译:

关于艾滋病毒/艾滋病的传播鸟分枝杆菌:历史和最新文献评论。

联合抗逆转录病毒疗法(cART)改变了鸟分枝杆菌的流行病学。在cART前和cART后期间,发现弥散的鸟分枝杆菌复合物(DMAC)感染的发生率显着降低。相比之下,从1990年到1996年,DMAC的诊断率增加了一倍以上。在此期间,发达国家的AIDS感染者(PLHA)的DMAC患病率总体达到20-23%,而CD4细胞计数<10个细胞的人群中> 40% / mm3。目前,PLHA中的DMAC每1000患者年发生两次事件。最近,疾病控制中心更改了MAC一级预防的标准,在该标准中,仅对没有立即cART和CD4细胞计数<50细胞/ mm3的患者每周开处方1200 mg阿奇霉素。当患者启动有效的cART时,治疗将中断。由于液体培养的准确性较低且缺乏诊断过程,因此难以诊断弥散的鸟分枝杆菌感染。但是,尚未评估DMAC和HIV / AIDS等新型分子技术(如全基因组测序)的有用性。由于无法正确诊断和治疗,DMAC的死亡率很高,因此我们对HIV / AIDS和DMAC流行病学,危险因素,预防,临床表现,诊断,预后和治疗进行了文献综述。
更新日期:2020-08-21
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