《WHO无症状结核病咨询报告》解读

doi:10.19871/j.cnki.xfcrbzz.2025.05.018

摘要/Abstract

摘要： 结核病（tuberculosis,TB）是全球发病率和致死率较高的传染性疾病,受结核分枝杆菌(Mycobacterium tuberculosis,MTB）和机体免疫状态的相互影响,结核病从病情最轻的无症状感染到病情最严重的播散性结核病的临床表现各有不同。目前已经公认的是,免疫功能正常个体发生MTB感染后多呈无症状结核潜伏感染状态,仅5%~10%结核潜伏感染者最终可能进展为活动性结核病。无症状结核病（asymptomatic tuberculosis,aTB）因症状隐匿易致诊治延误,而其临床和公共卫生学意义未引起足够关注。基于以上原因,2025年2月28日WHO发布了《WHO无症状结核病咨询报告》,内容涵盖结核病的自然史、aTB的概念、临床和公共卫生意义、提出aTB新定义的理由以及优先研究方向和关键点等。本文旨在解读《WHO无症状结核病咨询报告》的核心内容,呼吁重视aTB给临床诊疗和公共卫生工作带来的潜在影响,推动解决相关问题,助力WHO“终止结核病”目标的实现。

关键词: 无症状结核病, 无症状结核潜伏感染, 世界卫生组织, 临床诊断结核病, 解读

Abstract: Tuberculosis (TB) remains a leading infectious disease of morbidity and mortality worldwide. The clinical manifestations spectrum of TB, which driven by the interaction between Mycobacterium tuberculosis (MTB) and immunological status of the host, range from the mildest asymptomatic condition to the most serious disseminated stage. It is well established that most infected immunocompetent individuals are asymptomatic status, with only 5%～10% of these individuals will eventually develope to active TB during their lifetime. Because of asymptomatic or imperceptibly mild symptoms, the diagnosis and treatment of these patients with asymptomatic tuberculosis (aTB) are often delayed. Furthermore, the clinical and public health significance of aTB has not been given sufficient attention. For the above reasons, the World Health Organization (WHO) released the Report of WHO Consultation on Asymptomatic Tuberculosis on February 28th, 2025. This report includes the natural history of TB, the definition of aTB its clinical and public health significance of aTB, and its clinical and public health significance, and the rationale for a revised definition of aTB. Additionally, it outlines the priority research directions and critical knowledge gaps. This paper aims to highlight the key findings of the WHO consultation on asymptomatic tuberculosis, while also calling for greater awareness of the potential impact of aTB on clinical diagnosis and treatment as well as public health work, which will promote the solutions to related issues and advance progress toward WHO's goal of End-TB.

Key words: Asymptomatic tuberculosis, Asymptomatic latent infection of tuberculosis, World Health Organization, Clinically diagnosed TB, Interpretation

中图分类号:

詹梅, 赵颂涛, 郭建琼, 李同心, 杨松. 《WHO无症状结核病咨询报告》解读[J]. 新发传染病电子杂志, 2025, 10(5): 100-104.

Zhan Mei, Zhao Songtao, Guo Jianqiong, Li Tongxin, Yang Song. The interpretation of the Report of WHO Consultation on Asymptomatic Tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(5): 100-104.

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