RT Journal Article
SR Electronic
T1 Should tuberculosis treatment and control be addressed differently in HIV-infected and -uninfected individuals?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 751
OP 757
DO 10.1183/09031936.05.10090404
VO 25
IS 4
A1 Dlodlo, R. A.
A1 Fujiwara, P. I.
A1 Enarson, D. A.
YR 2005
UL http://erj.ersjournals.com/content/25/4/751.abstract
AB Infection with HIV drives the tuberculosis epidemic, especially in sub-Saharan Africa, where up to 75% of individuals with tuberculosis are co-infected with HIV. This article reviews the epidemiological link between the conditions, how tuberculosis diagnosis and treatment differ between HIV-infected versus -uninfected individuals and the span of additional measures required to prevent and control HIV-related tuberculosis. Tuberculosis chemotherapy using standard short-course regimens is highly effective in both groups, and treatment follows the same principles. It differs in certain aspects, such as when antiretroviral treatment should be started in HIV-infected individuals with tuberculosis and consideration of drug–drug interactions between the rifamycins and certain antiretroviral drugs. Control of HIV-related tuberculosis requires, fundamentally, control of HIV transmission. Meanwhile, it is necessary to make concentrated efforts to intensify high-quality tuberculosis services employing the directly observed treatment, short-course (DOTS) strategy, carry out extensive research towards an evidence-based model for the expanded scope of collaborative tuberculosis and HIV/AIDS interventions, and ensure efficient implementation of the findings and recommended policies. The challenge is gigantic, and both robust within-country and international leadership and competent management capabilities will be required, in addition to substantial human and financial resources. SERIES “CONTROVERSIAL ISSUES IN TUBERCULOSIS” Edited by A. Torres and J. Caminero Number 5 in this Series