1、 Chin J Tuberc Respir Dis,2002.Yu,et al.Chin J Lab Med,2009 Incidence of death among persons with HIV/AIDSPer 100-person YearsYear of Diagnosis 72%p .0001 *2009 MMWRIn low HIV prevalence area:HIV positivity rate in TB patients=5-10 times of HIV prevalence in general population 低低HIV流行区流行区:活动性结核患者的活动
2、性结核患者的HIV阳性率阳性率 人群人群HIV患病率患病率 x（5-10）倍）倍在不同状态下结核病的症状和体征症状/体征HIV 阳性(%)HIV 阴性(%)呼吸困难发热盗汗体重下降腹泻肝肿大脾肿大淋巴结肿大9779838923414035816264834211513Chest 1994;106:1471-6 结核发生的类型（部位）SiteHIV positive(%)HIV negative(%)肺肺外两者胸膜心包淋巴结4034263115197216121933J Trop Med Hygiene 1993;96:1-1121.5 7.8%P=0.003,log-rank 8.3 5.9%
3、CD4100,twice-weeklyCD4100Mechanisms of Drug Interactions Involving Antituberculosis DrugsMechanismExamplesEffect onother drugsClinicaleffectP450 InductionP450 InhibitionBinding in the GI tractRIF RPT RBTRTV NLV,IDV SQVAntacids(DDI),Fe,Zn levels levels levels efficacy toxicity efficacyEffect of rifam
4、ycins on serum concentrations(AUC)of protease inhibitorsRifabutinRifampinPISaquinavirRitonavirIndinavirNelfinavirAmprenavirLopinavir/ritonavirAtazanavir 46%NR 24%0-23%14%No effectNo effect 80%35%90%82%81%75%not doneEffect of protease inhibitors on serum concentrations(AUC)of rifamycins RifabutinRifa
5、mpinPISaquinavirRitonavirIndinavirNelfinavirAmprenavirLopinavir/ritonavirAtazanavir 45%400%270%200%400%300%250%NRunchangedNRNRNRNRNREffect of rifamycins on serum concentrations(AUC)of NNRTIsNNRTIRifabutinRifampinNevirapine 16%37%Delavirdine 80%96%Efavirenzunchanged 13%Overlapping side effect profiles of first-lineantituberculosis drugs and antiretroviral drugsSide effectPossible causesAntituberculosis drugsAntiretroviral drugsSkin rashNausea,vomitingHepatitsLeukopenia,anemiaPZA,INHPZA,RBT,INHPZA,RBT,INHRBTNVP,DVL,EFV,ABCAZT,AMP,IDVNVP,PIs,immunereconstitutionAZT%
