Tuberculosis and HIV Infection: A Global Perspective

Abstract

The incidence of HIV-associated tuberculosis has been increasing worldwide since the beginning of the AIDS epidemic, and is expected to increase even further during the foreseeable future, especially in developing countries. There is no doubt now that, in the presence of HIV infection, new-onset tuberculous infection progresses rapidly to clinically significant disease and the likelihood that latent tuberculous infection progresses rapidly to clinically significant disease and the likelihood that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is contributing to the increasing incidence of disease caused by multidrug-resistant strains of Mycobacterium tuberculosis. Neither clinical features nor radiographic abnormalities reliably distinguish the majority of patients with HIV-associated tuberculosis from those without HIV infection. Some persons with HIV infection, however, present with atypical manifestations of tuberculosis and these patients may be difficult to diagnose. Six months of daily or thrice weekly chemotherapy with the usual regimen of 4 then 2 antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.

Vaccine-Elicited 10-Kilodalton Culture Filtrate Protein-Specific CD8 + T Cells Are Sufficient To Mediate Protection against Mycobacterium tuberculosis Infection

“…Overlapping peptides spanning the CFP-10 protein sequence of M. tuberculosis have previously been described (13). In addition, CFP-10 32-39 , CFP-10 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] , and ESAT-6 53-75 were commercially synthesized (Biosource International). The peptides were dissolved in dimethyl sulfoxide and stored at Ϫ20°C until used.…”

“…ϩ T cells has been extensively documented, and the increased susceptibility of human immunodeficiency virus-infected people to tuberculosis underlines the importance of CD4 ϩ T cells in preventing the disease caused by M. tuberculosis (22). On the other hand, the role of CD8 ϩ T cells in immunity to M. tuberculosis is still being elucidated.…”

“…Two distinct CFP-10 epitopes are recognized by T cells elicited following M. tuberculosis infection of C3H mice. One, CFP-10 32-39 , is recognized by CD8 ϩ T cells, and the other, CFP-10 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] , is recognized by CD4 ϩ T cells (14). In order to determine whether CFP-10-specific CD8 ϩ T cells can mediate host resistance to M. tuberculosis, we sought to develop a vaccination strategy that elicits only CFP-10 32-39 -specific CD8 ϩ T cells.…”

A thousand years of pulmonary medicine: good news and bad

“…7) published just a few years ago by WHO [14], but recently ammended [15]. I suspect the global tuberculosis situation will continue to deteriorate, at least for awhile, because it has proven immensely difficult to contain the disease in the face of a high prevalence of HIV infection, even in countries that have good tuberculosis control programmes [16]. So as long as HIV continues to propagate in places where as many as half the adults are already infected with tubercle bacilli, tuberculosis will remain a serious global problem.…”

Predisposing factors for multi drug resistant Tuberculosis in Southest Region of Turkey

“…MDR TB first emerged in the 1990s when high mortality rates followed outbreaks in hospitals, in the United States. DR has often been the result of inappropriately or poorly implemented primary programs for the control of TB (Murray, 1998 Treatment for MDR is more complex, toxic and expensive, and also less effective, than treatment for TB that is susceptible to all drugs (Espinal et al, 2001), and is successful in only 60 to 70% of cases (Mitnick et al, 2003). Because of the current global economic crisis, the cost of MDR TB is particularly critical for many countries.…”