Thursday , January 20 2022

[건강한 가족]"One of three or four people in the nation, Latin tuberculosis, total risk group,


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Interview Professor, Dept. of Respiratory Medicine, Asan Medical Center, Seoul, Korea

Professor Shim Tae Sun of Asan Medical Center, Seoul, Korea, describes the testing and treatment of high risk patients with latent tuberculosis at high risk. Freelance Kim Dong-Ha

Korea is considered a "backbone" in the management of tuberculosis. The incidence of tuberculosis is 77 per 100,000 population, so it is one of the countries of the Organization for Economic Co-development and Development (OECD). More than 30,000 new types of tuberculosis are any case, and approximately 2,000 (as in 2016) will die from tuberculosis. The key is management for the start. Experts emphasize that it is important to effectively diagnose and administer home tuberculosis with a high risk of coming, as well as the apparent tuberculosis. We interview Professor Shim Tae Sun of the Department of Medicine in Aspiration in Seoul, Korea.

Q: Tuberculosis patients rarely reduced.
A: "Tuberculosis comes in two ways, first of all, it is directly from a patient with tuberculosis, or secondly transmitted by tuberculosis (latent tuberculosis), which is hidden in the body is a development of weak immunity. This is not uncommon for people who have been infected in tuberculosis in the past in order to conceive of age by using or using immunosuppressive drugs. Only visible TB patients means it is difficult to earn the infectious disease and mortality of tuberculosis. "

Q: Is treatment of all patients with latent tuberculosis a problem?
A: "One to one quarter of the population is latent tuberculosis patients, 90% of latte tuberculosis does not develop tuberculosis. It does not carry mycobacteria and has no health problems, both testing and treating latent tuberculosis for the full population can not only cost effective, but can also develop into adverse medical adverse effects and social confusion. Therefore, in academia, only high risk patients are likely to develop the actual tuberculosis between the latte tuberculosis is selected and treated. In advanced countries, the tests are mainly performed for high-sex groups. "

Q: In some cases, it's a high risk group.
A: "Those who have been absorbed or have an immunosuppression to organ transplantation, patients who write or use therapeutic targets for TNP antagonists, and those in the last Two years at tuberculosis are at higher risk. In addition, patients with diabetes or chronic renal impairment are advised to diagnose and treat the Latin tuberculosis according to patients with a general risk group (less risky group). "

Q: How to diagnose latent tuberculosis.
A: "It is not possible to directly identify TB bacteria in the body Instead, they use an indirect method to determine if there are an immunizations that the product is infectious with M. tuberculosis.There are large tuberculosis test (TST) and interferon gamma secretion test (IGRA). "

Q: Any test method is explained in detail.
A: "TST is a test to investigate whether tuberculosis is infected by injection tuberculin (PPD) from Mycobacterium tuberculosis in skin and see the swollen size When a # In the case of protein, it is not promoted with tuberculosis, but may be positive The BCG is remarkable after one year of age, or two or more times, the false positive rate is 20 to 40%, and IGRA is complementary to this. and the Mycobacterium tuberculosis not found in BCG are mixed in the laboratory to determine the infection.Theoretical BCG vaccine has no risk of false positives. Currently, the healthy authorities use the IGRA test to recognize the presence of tuberculosis.

Q: Health Insurance is applied to diagnosis and treatment of latent tuberculosis. Only high risk one.
A: "No, at this time, Korea is also corrupted by dialysis copies that are serious from serious illness or silicosis (silicosis accumulation by dust inhalation). latent tuberculosis. With regard to this, Korea is expected to upgrade these patients to high-risk patients. "

Q: How much latent tuberculosis is treated.
A: "Latin tuberculosis can spend three months of 90% of the two types of medicines, especially those who are at high risk of developing tuberculosis and are likely to lose their lives due to severe tuberculosis. Desirable to treat unwanted treatment if there is a whole risk group.The problem is that high risk patients are not 100% tested for latent tuberculosis In the past, the tuberculosis was so serious that most tuberculosis was excluded from medical education At present, the trained medical staff is not aware of diagnosis and treatment of latent tuberculosis, I think education for medical staff should be expanded. "

Park Jung-ryul reporter [email protected]

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