Tuberculosis, drug resistance, and HIV/AIDS: A triple threat

Article

Abstract

The worldwide epidemics of tuberculosis (TB) and HIV/AIDS have been joined by an insidiously developing third epidemic of TB drug resistance. Fueled by the disruption of TB control programs and the explosive growth of HIV/AIDS, the presence of TB drug resistance, particularly multiple drug resistance, is worldwide and threatens the gains made in the past decades in the treatment of both TB and HIV. Although treatment success is possible, the diagnosis and treatment of drug-resistant TB is difficult. Advances in TB diagnosis and treatment have been minimal in the past 40 years, and there is an urgent need for wider distribution of available diagnostic technology and for the development and testing of newer rapid molecular diagnostic techniques and therapeutic agents. This review discusses current information about the distribution of multiple drug-resistant and newer extensively drug-resistant TB as well as available diagnostic and therapeutic strategies with an emphasis on the relationship between TB drug resistance and HIV/AIDS.

References and Recommended Reading

  1. 1.
    Corbett EL, Marston B, Churchyard GJ, De Cock KM: Tuberculosis in sub-Saharan Africa: Opportunities, challenges, and change in the era of antiretroviral treatment. Lancet 2006, 367:926–937.PubMedCrossRefGoogle Scholar
  2. 2.
    World Health Organization: Global Tuberculosis Control Surveillance, Planning, Financing. Geneva: World Health Organization; 2006.Google Scholar
  3. 3.
    World Health Organization: Treatment of Tuberculosis: Guidelines for National Programmes, 3rd edn. Geneva: World Health Organization; 2006.Google Scholar
  4. 4.
    UNAIDS, World Health Organization: AIDS Epidemic Update, December 2005. Geneva: World Health Organization; 2005.Google Scholar
  5. 5.
    Frieden TR, Fujiwara PI, Washko RM, Hamburg MA: Tuberculosis in New York City-Turning the tide. N Engl J Med 1995, 333:229–233.PubMedCrossRefGoogle Scholar
  6. 6.
    Reichman L, Tanne J: Timebomb: The Global Epidemic of Multi-Drug Resistant Tuberculosis. New York: McGraw Hill; 2001.Google Scholar
  7. 7.
    Wilkinson D, Davies GR: The increasing burden of tuberculosis in rural South Africa—impact of the HIV epidemic. S Afr Med J 1997, 87:447–450.PubMedGoogle Scholar
  8. 8.
    De Cock KM, Wilkinson D: Tuberculosis control in resource poor countries: alternative strategies in the era of HIV. Lancet 1995, 346:675–677.PubMedCrossRefGoogle Scholar
  9. 9.
    Friedland G, Abdool-Karim S, Abdool-Karim Q, et al.: Utility of tuberculosis directly observed therapy programs as sites for access to and provision of antiretroviral therapy in resource-limited countries. Clin Infect Dis 2004, 38:S421–428.PubMedCrossRefGoogle Scholar
  10. 10.
    World Health Organization: Scaling up Antiretroviral Therapy in Resource-limited Settings: Guidelines for a Public Health Approach. Geneva: World Health Organization; 2006.Google Scholar
  11. 11.
    World Health Organization/International Union Against Tuberculosis and Lung Disease Global Project on Anti-Tuberculosis Drug Resistance Surveillance: Anti-tuberculosis Drug Resistance in the World: Report no. 3. Geneva: World Health Organization; 2004.Google Scholar
  12. 12.
    Nathanson E, Lambregts-van Weezenbeek C, Rick ML, et al.: Multidrug-resistant tuberculosis management in resource-limited settings. Emerg Infect Dis 2006, 12:1389–1397.PubMedGoogle Scholar
  13. 13.
    US Centers for Disease Control and Prevention: Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs-worldwide 2000–2004. Morb Mortal Wkly Rep 2006, 55:301–305.Google Scholar
  14. 14.
    World Health Organization: Meeting of the Global XDR TB Task Force. Geneva; October 9–10, 2006.Google Scholar
  15. 15.
    Rattan A, Kalia A, Ahmad N: Multidrug-resistant mycobacterium tuberculosis: molecular perspectives. Emerging Infect Dis 1998, 4:2.CrossRefGoogle Scholar
  16. 16.
    World Health Organization: Guidelines for the Programmatic Management of Drug-resistant Tuberculosis, vol. 361. Geneva: World Health Organization; 2006.Google Scholar
  17. 17.
    Mukherjee J, Rich ML, Socci AR, et al.: Programmes and principles in treatment of multidrug-resistant tuberculosis. Lancet 2004, 363:474–481.PubMedCrossRefGoogle Scholar
  18. 18.
    Zignol M, Hosseini MS, Wright A, et al.: Global incidence of multidrug-resistant tuberculosis. J Infect Dis 2006, 194:479–485.PubMedCrossRefGoogle Scholar
  19. 19.
    Weyer K, Lancaster J, Brand J, et al.: Survey of Tuberculous Drug Resistance in South Africa, 2001–2002 (Technical report to the Department of Health, June). Tygerberg, South Africa: Medical Research Council of South Africa; 2003.Google Scholar
  20. 20.
    Nunes EA, De Capitani EM, Coelho E, et al.: Patterns of antituberculosis drug resistance among HIV infected patients in Maputo, Mozambique, 2002–2003. Int J Tuberc Lung Dis 2005, 9:494–500.PubMedGoogle Scholar
  21. 21.
    Nelson LJ, Talbot EA, Mwasekaga MJ, et al.: Antituberculosis drug resistance and anonymous HIV surveillance in tuberculosis patients in Botswana, 2002. Lancet 2005, 366:488–490.PubMedCrossRefGoogle Scholar
  22. 22.
    Gandhi NR, Moll A, Pawinski R, et al.: Favorable outcomes of integration of TB and HIV treatment in a rural South Africa: The Sizonq’oba study [abstract]. Presented at the XVI International Conference on AIDS. Toronto; August 13–18, 2006.Google Scholar
  23. 23.
    Gandhi NR, Moll A, Sturm AW, et al.: Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 2006, 368:1575–1580.PubMedCrossRefGoogle Scholar
  24. 24.
    Centers for Disease Control and Prevention (CDC): Trends in tuberculosis—United States, 2005. MMWR Morb Mortal Wkly Rep 2006, 55:305–308.Google Scholar
  25. 25.
    Campos PE, Suarez PG, Sanchez J, et al.: Multidrug-resistant Mycobacterium tuberculosis in HIV-infected persons, Peru. Emerging Infect Dis 2003, 9:1571–1578.PubMedGoogle Scholar
  26. 26.
    Kim S: Drug-susceptibility testing in tuberculosis: methods and reliability of results. Eur Respir J 2005, 25:564–569.PubMedCrossRefGoogle Scholar
  27. 27.
    Foundation for Innovative Diagnostics (FIND). http://www.finddiagnostics.org/. Accessed February 13, 2007.
  28. 28.
    Perkins MD, Small PM: Partnering for better microbial diagnostics. Nat Biotechnol 2006, 24:919–921.PubMedCrossRefGoogle Scholar
  29. 29.
    Partners In Health: The PIH Guide to the Medical Management of Multidrug-Resistant Tuberculosis. United States: Partners In Health; 2003. http://www.pih.org/inforesources/MDRTB/PIH_Guide_book_final.pdf. Accessed February 19, 2007.
  30. 30.
    World Health Organization: DOTS-Plus and the Green Light Committee. http://www.who.int/tb/dots/dotsplus/management/en/. Accessed March 7, 2007.
  31. 31.
    Espinal MA, Kim SJ, Suarez PG, et al.: Standard short-course chemotherapy for drug-resistant tuberculosis, treatment outcomes in 6 countries. JAMA 2000; 283:2537–2545.PubMedCrossRefGoogle Scholar
  32. 32.
    Mitnick C, Bayona J, Palacios E, et al.: Community-based therapy for multidrug-resistant tuberculosis in Lima, Peru. N Engl J Med 2003, 348:119–128.PubMedCrossRefGoogle Scholar
  33. 33.
    Leimane V, Riekstina V, Holtz TH, et al.: Clinical outcome of individualized treatment of mutidrug-resistant tuberculosis in Latvia: a retrospective cohort study. Lancet 2005, 365:318–326.PubMedGoogle Scholar
  34. 34.
    Resch SC, Salomon JA, Murray M, Weinstein MC: Cost-effectiveness of treating multidrug-resistant tuberculosis. PloS Medicine 2006, 3:e241.PubMedCrossRefGoogle Scholar
  35. 35.
    Blumberg HM, Burman WJ, Chaisson RE, et al.: American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003, 167:603–662.PubMedCrossRefGoogle Scholar
  36. 36.
    Lalloo UG, Naidoo R, Ambaram A: Recent advances in the medical and surgical treatment of multi-drug resistant tuberculosis. Curr Opin Pulm Med 2006, 12:179–185.PubMedCrossRefGoogle Scholar
  37. 37.
    Caminero JA: Management of multidrug-resistant tuberculosis and patients in retreatment. Eur Respir J 2005, 25:928–936.PubMedCrossRefGoogle Scholar
  38. 38.
    Jack C, Lalloo U, Abdool-Karim Q, et al.: A pilot study of once-daily antiretroviral therapy integrated with tuberculosis directly observed therapy in a resource-limited setting. J Acquir Immune Defic Syndr 2004, 36:929–934.PubMedCrossRefGoogle Scholar
  39. 39.
    Dean GL, Edwards SG, Ives NJ, et al.: Treatment of tuberculosis in HIV infected persons in the era of highly active antiretroviral therapy. AIDS 2002, 16:75–83.PubMedCrossRefGoogle Scholar
  40. 40.
    van der Wal M, Weyer K, Lancastre J: A standardised approach to management of drug-resistant TB in South Africa. Presented at the South Africa Medical Research Council Expert Consultation on Drug-Resistant Tuberculosis. Johannesburg, South Africa; September 7–8, 2006.Google Scholar
  41. 41.
    World Health Organization: Extensively Drug-Resistant Tuberculosis. What, Where, How, and Action Steps. http://www.who.int/tb/xdr/xdrmap_mar_en.pdf. Accessed March 7, 2007.

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  1. 1.AIDS ProgramYale University School of MedicineNew HavenUSA

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