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首页> 外文期刊>Food and Nutrition Bulletin >Addressing tuberculosis in the context of malnutrition and HIV coinfection. (Special issue: Nutrition and food insecurity in relation to HIV and AIDS and tuberculosis)
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Addressing tuberculosis in the context of malnutrition and HIV coinfection. (Special issue: Nutrition and food insecurity in relation to HIV and AIDS and tuberculosis)

机译：在营养不良和艾滋病毒合并感染的情况下解决结核病。 （特别问题：与艾滋病毒和艾滋病以及结核病有关的营养和粮食不安全）

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Background. Tuberculosis is the second leading cause of infectious disease mortality (1.8 million/year), after HIV/AIDS. There are more than 9 million new cases each year. One-third of the worlds population, and 50% of adults in sub-Saharan Africa, South Asia, and Southeast Asia, are infected, representing an enormous pool of individuals at risk for developing the disease. The situation is complicated by the HIV/AIDS pandemic, widespread undernutrition, smoking, diabetes, increased mobility, and emergence of multi- and extensively drug-resistant tuberculosis. Objective. To review the scientific evidence about the interactions among tuberculosis, nutrition, and HIV coinfection. Results. HIV infection and malnutrition lower immunity, increasing the risk of reactivation tuberculosis and primary progressive disease. Having either tuberculosis or HIV infection causes weight loss. Malnutrition markedly increases mortality among both tuberculosis and HIV/AIDS patients and should be treated concurrently with treatment of the infections. Tuberculosis treatment is a prerequisite for nutritional recovery, in addition to intake of nutrients required for rebuilding tissues, which is constrained in food-insecure households. Additional pharmaceutical treatment to reduce the catabolic impact of inflammation or promote growth may be needed. Specific nutrients can contribute to faster sputum smear clearance, which is important for reducing transmission, as well as faster weight gain when combined with an adequate diet. Adequate nutrition and weight gain in undernourished populations might reduce the incidence of tuberculosis. Conclusions. The many risk factors for the development of tuberculosis need to be addressed simultaneously, especially HIV/AIDS and food insecurity and undernutrition. For stronger evidence-based guidelines, existing recommendations and clinical applications need to be more widely applied and evaluated.
机译：背景。结核病是仅次于艾滋病毒/艾滋病的第二大传染病死亡率（180万/年）。每年有超过900万新病例。撒哈拉以南非洲地区，南亚和东南亚地区，世界人口的三分之一以及成年人的50％被感染，这代表着罹患这种疾病的巨大风险人群。艾滋病毒/艾滋病大流行，营养不良，吸烟，糖尿病，行动不便以及多重耐药和广泛耐药结核病的出现使情况变得复杂。目的。审查有关结核病，营养和HIV合并感染之间相互作用的科学证据。结果。艾滋病毒感染和营养不良会降低免疫力，增加患肺结核和原发性进行性疾病的风险。患有结核病或感染HIV都会导致体重减轻。营养不良显着增加结核病和艾滋病毒/艾滋病患者的死亡率，应与感染同时治疗。除摄入重建组织所需的营养外，结核病治疗是营养恢复的先决条件，这在粮食不安全的家庭中受到限制。可能需要其他药物治疗以减少炎症的分解代谢影响或促进生长。特定的营养成分可以加快痰液涂片清除的速度，这对于减少传播很重要，并且在与适当的饮食相结合时可以更快地增加体重。营养不良人口的充足营养和体重增加可能会减少结核病的发病率。结论需要同时解决结核病发展的许多风险因素，尤其是艾滋病毒/艾滋病以及粮食不安全和营养不良。为了获得更强大的循证指南，需要更广泛地应用和评估现有的建议和临床应用。

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