Challenges and perspectives for improved management of HIV/Mycobacterium tuberculosis co-infection

Abstract

HIV and Mycobacterium tuberculosis (MTB) are two widespread and highly successful microbes whose synergy in pathogenesis has created a significant threat for human health globally. In acknowledgement of this fact, the European Union (EU) has funded a multinational support action, the European Network for global cooperation in the field of AIDS and TB (EUCO-Net), that brings together experts from Europe and those regions that bear the highest burden of HIV/MTB co-infection. Here, we summarise the main outcome of the EUCO-Net project derived from an expert group meeting that took place in Stellenbosch (South Africa) (AIDS/TB Workshop on Research Challenges and Opportunities for Future Collaboration) and the subsequent discussions, and propose priority areas for research and concerted actions that will have impact on future EU calls.

What Factors May Influence Epidemiological Situation of Tuberculosis in Poland and in the World?

“…The development and course of tuberculosis in such a case is usually very abrupt, and may be the cause of death of the patient [26,30,31].…”

“…Treatment with HAART creates however another problems. There is some interaction between those drugs and rifampicin, and in addition, there is a risk of development of immune reconstitution inflammatory syndrome (IRIS) [30,31].…”

World-Wide Challenges and Perspectives for Handling HIV/Mycobacterium tuberculosis Co-Infections

“…As a consequence, TB has become the leading cause of mortality for people living with HIV/AIDS, even in regions where highly active antiretroviral therapy (ART) has been implemented, and HIV is the most potent force driving the TB epidemic in countries with a high prevalence of HIV infection. Currently, this "cursed duet" of AIDS/TB is exerting its detrimental effects in settings where HIV and MTB prevalence is highest (such as in Sub-Saharan Africa, India, Russia or Latin America) and where multidrug-(MDR) and extensively drug resistant TB (XDR-TB) are present [2][3][4].…”

Avaliação da utilidade clínica de novos testes diagnósticos em tuberculose: o papel dos ensaios clínicos pragmáticos

“…(9) The diagnostic yield of sputum smear microscopy for AFB is low (40-60%), principally in patients with low bacterial load in respiratory samples, as occurs in HIV-positive patients and in those with other immunosuppressive diseases (30%). (10) For thirty years, the WHO no longer considered tuberculosis research a priority; however, in 2006, through the Stop TB Partnership Second Global Plan to Stop TB, the WHO again recommended that tuberculosis research be conducted in the areas of development and evaluation of new diagnostic methods, drugs, vaccines, and management strategies. (11) An increase in the diagnosis of paucibacillary tuberculosis, tuberculosis/HIV co-infection, and MDR-TB was therefore essential to the success of the plan, given that rapid diagnosis of tuberculosis allows the initiation of pharmacological treatment and reduces the length of time for which the chain of transmission is maintained, therefore reducing the number of individuals infected by those with the disease.…”