Tiberi, S;
Carvalho, ACC;
Sulis, G;
Vaghela, D;
Rendon, A;
Mello, FCDQ;
Rahman, A;
... Pontali, E; + view all
(2017)
The cursed duet today: Tuberculosis and HIV-coinfection.
Presse Medicale
, 46
(2)
E23-E39.
10.1016/j.lpm.2017.01.017.
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Abstract
The tuberculosis (TB) and HIV syndemic continues to rage and are a major public health concern worldwide. This deadly association raises complexity and represent a significant barrier towards TB elimination. TB continues to be the leading cause of death amongst HIV-infected people. This paper reports the challenges that lay ahead and outlines some of the current and future strategies that may be able to address this co-epidemic efficiently. Improved diagnostics, cheaper and more effective drugs, shorter treatment regimens for both drug-sensitive and drug-resistant TB are discussed. Also, special topics on drug interactions, TB-IRIS and TB relapse are also described. Notwithstanding the defeats and meagre investments, diagnosis and management of the two diseases have seen significant and unexpected improvements of late. On the HIV side, expansion of ART coverage, development of new updated guidelines aimed at the universal treatment of those infected, and the increasing availability of newer, more efficacious and less toxic drugs are an essential element to controlling the two epidemics. On the TB side, diagnosis of MDR-TB is becoming easier and faster thanks to the new PCR-based technologies, new anti-TB drugs active against both sensitive and resistant strains (i.e. bedaquiline and delamanid) have been developed and a few more are in the pipeline, new regimens (cheaper, shorter and/or more effective) have been introduced (such as the “Bangladesh regimen”) or are being tested for MDR-TB and drug-sensitive-TB. However, still more resources will be required to implement an integrated approach, install new diagnostic tests, and develop simpler and shorter treatment regimens.
| Type: | Article |
|---|---|
| Title: | The cursed duet today: Tuberculosis and HIV-coinfection |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.lpm.2017.01.017 |
| Publisher version: | https://doi.org/10.1016/j.lpm.2017.01.017 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, DRUG-RESISTANT TUBERCULOSIS, IMMUNODEFICIENCY-VIRUS-INFECTION, RECONSTITUTION INFLAMMATORY SYNDROME, DIAGNOSED PULMONARY TUBERCULOSIS, STARTING ANTIRETROVIRAL THERAPY, PLACEBO-CONTROLLED TRIAL, RIO-DE-JANEIRO, SOUTH-AFRICA, MYCOBACTERIUM-TUBERCULOSIS, RECURRENT TUBERCULOSIS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10048879 |
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| 2. |  India | 2 |
| 3. |  Russian Federation | 2 |
| 4. |  China | 2 |
| 5. |  Thailand | 1 |
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| 8. |  South Africa | 1 |
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