Tuberculosis in HIV-infected persons in the context of wide availability of highly active antiretroviral therapy

Girardi, Enrico; Antonucci, Giorgio; Vanacore, Paola; Palmieri, Fabrizio; Matteelli, Alberto; Iemoli, Enrico; Carradori, Silvia; Salassa, B; Pasticci, Maria Bruna; Raviglione, Mario; Ippolito, Giuseppe

doi:10.1183/09031936.04.00109303

Cited by 48 publications

(34 citation statements)

References 28 publications

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“…Conversely, others showed that the response to mitogen was not impaired [10,21,35]; however, this was due probably to the selected HIV-infected population characterized by a relatively high median CD4 + T cell count, 361 and 392 CD4 + T cell/ml, respectively [10,21] and by a high proportion of subjects with CD4 + T cell counts higher than 200 cell/ml (87%) compared to our population (45%) [35]. These findings together support the hypothesis that the performance of the IFN-g assays can be affected negatively in patients with advanced immune suppression who unfortunately in western countries are those at high risk of developing active tuberculosis, also in the HAART era [36].…”

Section: Discussionsupporting

confidence: 82%

Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

Vincenti

Carrara

Butera

et al. 2007

Clinical and Experimental Immunology

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Summary Tuberculosis is the most frequent co-infection in human immunodeficiency+ T cell counts, but not with plasma HIV-RNA load. Moreover, the RD1 selected peptides assay had the highest diagnostic odds ratio for active tuberculosis compared to tuberculin skin test (TST), QuantiFERON-TB Gold and T-SPOT.TB. RD1 selected peptides assay is associated with M. tuberculosis replication in HIV-infected individuals, although T cell anergy remains an important obstacle to be overcome before the test can be proposed as a diagnostic tool.

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Section: Discussionsupporting

confidence: 82%

Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

Vincenti

Carrara

Butera

et al. 2007

Clinical and Experimental Immunology

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“…The use of antiretroviral therapy (ART) in these patients reduces the risk of developing active TB [32,33,34], being associated in HIV-infected TB patients with higher rates of survival, when used during and after TB treatment [25,27,35]. We also found that ART reduces the risk of developing active TB in HIV-patients.…”

Section: Discussionsupporting

confidence: 49%

Factors related to HIV/tuberculosis coinfection in a Brazilian reference hospital

Carvalho¹,

Monteiro²,

Neto³

et al. 2008

Braz J Infect Dis

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Infection with both Human Immunodeficiency Virus (HIV) and Mycobacterium tuberculosis is currently the world's leading cause of death due to infectious agents. We evaluated factors related to the development of tuberculosis (TB) in HIV-infected patients who were being treated at an infectious diseases hospital in Fortaleza, Ceará, Brazil. From January 2004 to December 2005, we made an epidemiological study through the analysis of the medical records of 171 patients, who were diagnosed as having both HIV and tuberculosis. Among these co-infected patients, most (81%, p=0.0006) were male. Co-infection was more frequent (87.8%) among patients over 40 years of age and those with lower educational levels (less than eight years of schooling). Forty-one percent of the patients in the study had not had a smear culture test for acid-fast bacilli (AFB). CD4 cell counts were lower than 200 cells/µ µ µ µ µL in 71.9% of the patients, the mean being 169 cells/µ µ µ µ µL. This type of data is important for establishing strategies to improve the control of tuberculosis in HIV-infected patients.

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“…The use of ART and immunological recovery, a rise in CD4 counts, significantly decreased the incidence of TB, with the greatest effect on patients with restored CD4 cell counts above 500 cells/l (14,113,151,156,223). Additionally, treatment with ART and the restoration of cell-mediated immunity are associated with less extrapulmonary involvement in TB infection (112). However, despite ART treatment, the overall TB incidence rate for HIV-infected patients still remained approximately 10-fold higher than that for adults without HIV (156).…”

Section: Treatment With Antiretroviral Therapy Decreasesmentioning

confidence: 99%

HIV and Tuberculosis: a Deadly Human Syndemic

2011

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SUMMARY A syndemic is defined as the convergence of two or more diseases that act synergistically to magnify the burden of disease. The intersection and syndemic interaction between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have had deadly consequences around the world. Without adequate control of the TB-HIV syndemic, the long-term TB elimination target set for 2050 will not be reached. There is an urgent need for additional resources and novel approaches for the diagnosis, treatment, and prevention of both HIV and TB. Moreover, multidisciplinary approaches that consider HIV and TB together, rather than as separate problems and diseases, will be necessary to prevent further worsening of the HIV-TB syndemic. This review examines current knowledge of the state and impact of the HIV-TB syndemic and reviews the epidemiological, clinical, cellular, and molecular interactions between HIV and TB.

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Tuberculosis in HIV-infected persons in the context of wide availability of highly active antiretroviral therapy

Cited by 48 publications

References 28 publications

Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

Factors related to HIV/tuberculosis coinfection in a Brazilian reference hospital

HIV and Tuberculosis: a Deadly Human Syndemic

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