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应用肿瘤坏死因子拮抗剂人群结核潜伏感染的检测及预防性治疗

谭雨亭 侍效春 刘晓清

谭雨亭, 侍效春, 刘晓清. 应用肿瘤坏死因子拮抗剂人群结核潜伏感染的检测及预防性治疗[J]. 协和医学杂志, 2021, 12(1): 86-91. doi: 10.12290/xhyxzz.20180406
引用本文: 谭雨亭, 侍效春, 刘晓清. 应用肿瘤坏死因子拮抗剂人群结核潜伏感染的检测及预防性治疗[J]. 协和医学杂志, 2021, 12(1): 86-91. doi: 10.12290/xhyxzz.20180406
TAN Yu-ting, SHI Xiao-chun, LIU Xiao-qing. Testing and Prophylaxis of Latent Tuberculosis Infection in Patients Receiving Tumor Necrosis Factor-α Antagonists[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 86-91. doi: 10.12290/xhyxzz.20180406
Citation: TAN Yu-ting, SHI Xiao-chun, LIU Xiao-qing. Testing and Prophylaxis of Latent Tuberculosis Infection in Patients Receiving Tumor Necrosis Factor-α Antagonists[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 86-91. doi: 10.12290/xhyxzz.20180406

应用肿瘤坏死因子拮抗剂人群结核潜伏感染的检测及预防性治疗

doi: 10.12290/xhyxzz.20180406
基金项目: 

艾滋病和病毒性肝炎等传染病科技重大专项 2017ZX100201302-003

中国医学科学院医学与健康科技创新工程 2016-I2M-1-013

详细信息
    通讯作者:

    刘晓清  电话:010-69155087,E-mail:liuxqpumch@126.com

  • 中图分类号: R593.2;R52

Testing and Prophylaxis of Latent Tuberculosis Infection in Patients Receiving Tumor Necrosis Factor-α Antagonists

More Information
  • 摘要: 肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)拮抗剂的使用是发生活动性结核的高危因素,尤其对于潜伏结核感染(latent tuberculosis infection,LTBI)患者,结核再活动的风险更高。2015年世界卫生组织发布的LTBI管理指南强烈推荐在应用TNF-α拮抗剂前应进行LTBI筛查,并推荐了5种治疗方案,然而,该指南中关于5种方案在此类人群中的有效性和安全性尚无数据。接受TNF-α拮抗剂治疗人群LTBI的筛查和治疗方案选择应受到重视。本文主要综述应用TNF-α拮抗剂LTBI的筛查和治疗,以期为该类人群LTBI的管理提供依据。
    利益冲突  无
  • 表  1  应用TNF-α拮抗剂LTBI治疗方案指南或共识

    国家/地区(年份) LTBI治疗方案 抗结核治疗后开始TNF-α拮抗剂治疗时间
    中国(2013)[13] INH+RIF 6个月 ≥4周
    INH+RFT 6个月
    法国(2003)[19] INH+RIF 3个月 ≥3周
    INH 9个月
    英国(2005)[20] INH 6个月 ≥2个月; 若有异常胸片表现或结核
    INH+RIF 3个月 病史,完成预防治疗后开始
    西班牙(2005)[21] INH 9个月 1个月
    日本(2007)[22] INH 9个月 无明确推荐
    瑞士(2007)[23] INH 9个月 1个月
    RIF 4个月
    欧洲(2010)[24] INH 9~12个月 4周
    INH+RIF 3个月
    美国(2012)[25] 无明确推荐 1个月
    美国(2013)[26] INH 9个月 无明确推荐,倾向于完成预防治疗后开始
    INH 6个月
    INH+RIF 3个月
    RIF 4个月
    意大利(2011)[27] INH 9个月 1个月
    加拿大(2012)[28] INH 9个月 1~2个月
    TNF-α:肿瘤坏死因子-α; LTBI:潜伏结核感染; INH:异烟肼; RIF:利福平; RFT:利福喷丁
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出版历程
  • 收稿日期:  2018-09-17
  • 录用日期:  2019-05-13
  • 网络出版日期:  2019-06-05
  • 刊出日期:  2021-01-30

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