Clinical management of tuberculosis and HIV-1 co-infection.
Identifieur interne : 000479 ( PubMed/Corpus ); précédent : 000478; suivant : 000480Clinical management of tuberculosis and HIV-1 co-infection.
Auteurs : C. Schutz ; G. Meintjes ; F. Almajid ; R J Wilkinson ; A. PozniakSource :
- The European respiratory journal [ 1399-3003 ] ; 2010.
English descriptors
- KwdEn :
- AIDS-Related Opportunistic Infections (diagnosis), AIDS-Related Opportunistic Infections (drug therapy), Anti-HIV Agents (adverse effects), Anti-HIV Agents (therapeutic use), Antitubercular Agents (adverse effects), Antitubercular Agents (therapeutic use), Drug Interactions, Exanthema (chemically induced), Female, HIV Infections (drug therapy), HIV-1, Hepatitis (drug therapy), Humans, Male, Mycobacterium tuberculosis (isolation & purification), Peripheral Nervous System Diseases (chemically induced), Peripheral Nervous System Diseases (drug therapy), Tuberculosis (diagnosis), Tuberculosis (drug therapy), Viral Load (drug effects).
- MESH :
- chemical , adverse effects : Anti-HIV Agents, Antitubercular Agents.
- chemically induced : Exanthema, Peripheral Nervous System Diseases.
- diagnosis : AIDS-Related Opportunistic Infections, Tuberculosis.
- drug effects : Viral Load.
- drug therapy : AIDS-Related Opportunistic Infections, HIV Infections, Hepatitis, Peripheral Nervous System Diseases, Tuberculosis.
- isolation & purification : Mycobacterium tuberculosis.
- chemical , therapeutic use : Anti-HIV Agents, Antitubercular Agents.
- Drug Interactions, Female, HIV-1, Humans, Male.
Abstract
In many parts of the world the commonest serious opportunistic infection that occurs in HIV-1 infected persons is tuberculosis (TB). HIV-1 co-infection modifies the natural history and clinical presentation, and adversely affects the outcome of TB. Severe disseminated disease is well-recognised but it is increasingly appreciated that early disease characterised by very few or no symptoms is also common. Immunodiagnostic methods to ascertain latent TB in HIV-1 infected persons are compromised in sensitivity. Chemoprevention of HIV-1-associated TB is effective, its benefits are restricted to those which have evidence of immune sensitisation and appear short-lived in areas of high TB burden. Although promising advances in the microbiological diagnosis of TB have recently occurred, the diagnosis of HIV-1-associated TB remains difficult because of more frequent presentation as sputum negative or extrapulmonary disease. Management of co-infected patients can be complex because of overlapping drug toxicities and interactions. Nevertheless consensus is developing that antiretroviral therapy should be provided as soon as practicable after starting TB treatment in HIV-1 co-infected persons. This has the consequence of increasing the frequency of immune reconstitution inflammatory syndrome, the pathogenesis and management of which is poorly defined.
DOI: 10.1183/09031936.00110210
PubMed: 20947678
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Pozniak</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="RBID">pubmed:20947678</idno><idno type="pmid">20947678</idno><idno type="doi">10.1183/09031936.00110210</idno><idno type="wicri:Area/PubMed/Corpus">000479</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000479</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical management of tuberculosis and HIV-1 co-infection.</title><author><name sortKey="Schutz, C" sort="Schutz, C" uniqKey="Schutz C" first="C" last="Schutz">C. Schutz</name><affiliation><nlm:affiliation>Infectious Diseases Unit, GF Jooste Hospital, Manenberg, South Africa. charlottelouw@discoverymail.co.za</nlm:affiliation></affiliation></author><author><name sortKey="Meintjes, G" sort="Meintjes, G" uniqKey="Meintjes G" first="G" last="Meintjes">G. Meintjes</name></author><author><name sortKey="Almajid, F" sort="Almajid, F" uniqKey="Almajid F" first="F" last="Almajid">F. Almajid</name></author><author><name sortKey="Wilkinson, R J" sort="Wilkinson, R J" uniqKey="Wilkinson R" first="R J" last="Wilkinson">R J Wilkinson</name></author><author><name sortKey="Pozniak, A" sort="Pozniak, A" uniqKey="Pozniak A" first="A" last="Pozniak">A. Pozniak</name></author></analytic><series><title level="j">The European respiratory journal</title><idno type="eISSN">1399-3003</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS-Related Opportunistic Infections (diagnosis)</term><term>AIDS-Related Opportunistic Infections (drug therapy)</term><term>Anti-HIV Agents (adverse effects)</term><term>Anti-HIV Agents (therapeutic use)</term><term>Antitubercular Agents (adverse effects)</term><term>Antitubercular Agents (therapeutic use)</term><term>Drug Interactions</term><term>Exanthema (chemically induced)</term><term>Female</term><term>HIV Infections (drug therapy)</term><term>HIV-1</term><term>Hepatitis (drug therapy)</term><term>Humans</term><term>Male</term><term>Mycobacterium tuberculosis (isolation & purification)</term><term>Peripheral Nervous System Diseases (chemically induced)</term><term>Peripheral Nervous System Diseases (drug therapy)</term><term>Tuberculosis (diagnosis)</term><term>Tuberculosis (drug therapy)</term><term>Viral Load (drug effects)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Anti-HIV Agents</term><term>Antitubercular Agents</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Exanthema</term><term>Peripheral Nervous System Diseases</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>AIDS-Related Opportunistic Infections</term><term>Tuberculosis</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Viral Load</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>AIDS-Related Opportunistic Infections</term><term>HIV Infections</term><term>Hepatitis</term><term>Peripheral Nervous System Diseases</term><term>Tuberculosis</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Mycobacterium tuberculosis</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term><term>Antitubercular Agents</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Drug Interactions</term><term>Female</term><term>HIV-1</term><term>Humans</term><term>Male</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In many parts of the world the commonest serious opportunistic infection that occurs in HIV-1 infected persons is tuberculosis (TB). HIV-1 co-infection modifies the natural history and clinical presentation, and adversely affects the outcome of TB. Severe disseminated disease is well-recognised but it is increasingly appreciated that early disease characterised by very few or no symptoms is also common. Immunodiagnostic methods to ascertain latent TB in HIV-1 infected persons are compromised in sensitivity. Chemoprevention of HIV-1-associated TB is effective, its benefits are restricted to those which have evidence of immune sensitisation and appear short-lived in areas of high TB burden. Although promising advances in the microbiological diagnosis of TB have recently occurred, the diagnosis of HIV-1-associated TB remains difficult because of more frequent presentation as sputum negative or extrapulmonary disease. Management of co-infected patients can be complex because of overlapping drug toxicities and interactions. Nevertheless consensus is developing that antiretroviral therapy should be provided as soon as practicable after starting TB treatment in HIV-1 co-infected persons. This has the consequence of increasing the frequency of immune reconstitution inflammatory syndrome, the pathogenesis and management of which is poorly defined.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20947678</PMID><DateCreated><Year>2010</Year><Month>12</Month><Day>01</Day></DateCreated><DateCompleted><Year>2011</Year><Month>03</Month><Day>30</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1399-3003</ISSN><JournalIssue CitedMedium="Internet"><Volume>36</Volume><Issue>6</Issue><PubDate><Year>2010</Year><Month>Dec</Month></PubDate></JournalIssue><Title>The European respiratory journal</Title><ISOAbbreviation>Eur. Respir. 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Although promising advances in the microbiological diagnosis of TB have recently occurred, the diagnosis of HIV-1-associated TB remains difficult because of more frequent presentation as sputum negative or extrapulmonary disease. Management of co-infected patients can be complex because of overlapping drug toxicities and interactions. Nevertheless consensus is developing that antiretroviral therapy should be provided as soon as practicable after starting TB treatment in HIV-1 co-infected persons. 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