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S Rosen, M Maskew, A T Brennan, M P Fox, L Vezi, P D Ehrenkranz, W D F Venter
BACKGROUND: The World Health Organization recommends rapid (≤ 7 days) or same-day initiation of antiretroviral treatment (ART) for HIV-positive patients. South Africa adopted this recommendation in 2017, but multiple clinic visits, long waiting times, and delays for laboratory tests remain common. Streamlined approaches to same-day initiation that allow the majority of patients to start ART immediately, while ensuring that patients who do require additional services receive them, are needed to achieve national and international treatment program goals...
October 11, 2018: Trials
Olga Zvonareva, Willemien van Bergen, Nadezhda Kabanets, Aleksander Alliluyev, Olga Filinyuk
Tuberculosis (TB) remains a major global public health problem that has become a crisis fuelled by HIV and the increasing occurrence of antimicrobial resistance. What has been termed the biosocial nature of TB challenges effective control of the disease. Yet, biosocial interactions involved in the persistence of TB in diverse settings are difficult to systematically account for. The recently developed framework of syndemics provides a way to capture how complex health problems result from the interactions between diseases such as HIV and TB, and harmful social conditions such as unemployment, malnutrition and substance abuse...
October 9, 2018: Journal of Biosocial Science
Iheanyi O Okonko, Amaoge Anyanwu, Anwuli U Osadebe, Ngozi N Odu
Human Immunodeficiency Virus (HIV) and tuberculosis (TB) are considered as key players in the global health scene. This study sought to determine the prevalence of TB among HIV-positive attendees of the Directly Observed Treatment of Short Course (DOTS) program at the military hospital in Port Harcourt. The association of HIV prevalence with gender and age as risk factors was also determined. A total of 200 patients aged 15-65 years were screened. Re-screening for HIV was done for confirmation. The overall prevalence for anti-TB antibodies amongst HIV-positive individuals was 14...
October 8, 2018: Journal of Immunoassay & Immunochemistry
Dixitkumar Jayantibhai Kapadiya, Paresh V Dave, Bhavin Vadera, Pranav Govindbhai Patel, Sudhir Chawla, Deepak Saxena
Background: Tuberculosis (TB) is first opportunistic infection and leading cause of death among human immunodeficiency virus (HIV)/AIDS. Certainly, the prevalence of TB is expected to differ between general population and HIV-infected persons. This study was conducted to determine the prevalence of TB among newly diagnosed HIV-infected adults attending antiretroviral therapy (ART) center in the state of Gujarat, India. Materials and Methods: Cross-sectional study was carried out among newly diagnosed HIV-infected persons attending ART center from July 2012 to September 2012...
July 2018: Indian Journal of Community Medicine
Suzaan Marais, Izanne Roos, Ayesha Mitha, Vinod Patel, Ahmed I Bhigjee
OBJECTIVES: To describe the clinical presentation, spinal magnetic resonance imaging (MRI) findings and outcome of HIV-infected patients with tuberculosis (TB)-associated syringomyelia and to compare these findings between all HIV-infected and -uninfected cases published in the literature. METHODS: A retrospective observational study conducted over a 12.5-year period at a public-sector referral hospital in South Africa. HIV-infected adults with neurological TB in whom MRI confirmed a syrinx were included...
September 28, 2018: Journal of the Neurological Sciences
Poobalan Naidoo, Aliasgar Esmail, Jonathan G Peter, Malika Davids, Mohammed Fadul, Keertan Dheda
BACKGROUND: The World Health Organisation (WHO) recommends the use of adjunctive urine lipopolysaccharide lipoarabinomannan (LAM) testing in hospitalized HIV-infected persons with suspected tuberculosis (TB) and a CD4 count <100 cells/ml. However, the recommendation is conditional and uptake by individual treatment programs depends on perceived additional benefit. The aim of this study was to determine if adjunctive LAM testing had additional clinical benefits including reduction in health care-related use of resources...
October 4, 2018: International Journal of Infectious Diseases: IJID
Christopher R Sudfeld, Ashley Buchanan, Nzovu Ulenga, Donna Spiegelman, Expeditho Mtisi, Ellen Hertzmark, Aisa N Muya, David Sando, Ester Mungure, Mucho Mizinduko, Wafaie W Fawzi
OBJECTIVE: The objective of this study was to assess the effectiveness of a routine multivitamin supplementation program for adults living with HIV in Tanzania. DESIGN: We conducted a retrospective cohort study of 67,707 adults enrolled in the Dar es Salaam HIV care and treatment program during 2004-2012. METHODS: The Dar es Salaam HIV care and treatment program intended to provide all adult patients with multivitamin supplements (vitamins B-complex, C, and E) free of charge; however, intermittent stockouts and other implementation issues did not afford universal coverage...
October 4, 2018: AIDS
Solomon Weldegebreal Asgedom, Daniel Tesfaye, Yirga Legesse Nirayo, Tesfay Mehari Atey
OBJECTIVE: The main objective of this study was to assess time to death and associated risk factors among tuberculosis (TB) patients. RESULTS: A total of 769 TB patients were studied and of those, 87 (11.3%) patients died. All of the deaths occurred within 7 months of anti-tuberculosis therapy. Extra-pulmonary TB (AHR = 17.376, 95% CI; 3.88-77.86, p < 0.001) as compared to pulmonary TB and cotrimoxazole prophylaxis therapy (CPT) (AHR = 0.15, 95% CI; 0...
October 4, 2018: BMC Research Notes
Nathan Ford, Dermot Maher, Molebogeng Xheedha Rangaka, Annabel Baddeley, Satvinder Singh, Haileyesus Getahun
PURPOSE OF REVIEW: Guidelines developed by the WHO aim to provide recommendations to support best practice in health delivery, with a focus on low-income and middle-income countries. As part of the guideline development process, critical knowledge gaps are identified and one of the core functions of WHO guidelines is to set forth priorities for future research. A review of research priorities identified through the WHO guideline development has recently been promoted as one approach to building an overarching priority research agenda in a given area...
November 2018: Current Opinion in HIV and AIDS
Betina Durovni, Solange Cavalcante
PURPOSE OF REVIEW: Tuberculosis (TB) remains the leading cause of death in people living with HIV (PLHIV) despite the achievements in antiretroviral therapy coverage. TB preventive therapy (TPT) has proved efficacy but has been neglected and poorly implemented. We reviewed recent publications and guidelines about TPT in PLHIV. RECENT FINDINGS: High-quality studies showed that TPT has a durable effect, over 5 years, preventing TB and all-cause mortality. There is new evidence showing the noninferiority of shorter, rifamycin-based regimens of TPT increasing the options for treatment...
November 2018: Current Opinion in HIV and AIDS
Alexander Kay, Anthony J Garcia-Prats, Anna Maria Mandalakas
PURPOSE OF REVIEW: The detrimental synergy of colliding HIV and tuberculosis (TB) epidemics is most devastating among children and adolescents living with HIV (CALWH) who shoulder a disproportionate burden of all child TB mortality. RECENT FINDINGS: CALWH benefit less from Bacille-Calmette Guerin vaccination than HIV-uninfected children and are not receiving TB preventive therapy despite global recommendations. Further, the predictive utility of most diagnostic tools is reduced in CALWH...
November 2018: Current Opinion in HIV and AIDS
Rocío M Hurtado, Daniel Meressa, Anne E Goldfeld
PURPOSE OF REVIEW: This review aims to describe the key principles in treatment of drug-resistant tuberculosis (TB) in people living with HIV, including early access to timely diagnostics, linkage into care, TB treatment strategies including the use of new and repurposed drugs, co-management of HIV disease, and treatment complications and programmatic support to optimize treatment outcomes. These are necessary strategies to decrease the likelihood of poor treatment outcomes including lower treatment completion rates and higher mortality...
November 2018: Current Opinion in HIV and AIDS
Elsa du Bruyn, Nashied Peton, Hanif Esmail, Patrick J Howlett, Anna K Coussens, Robert J Wilkinson
PURPOSE OF REVIEW: Tuberculosis is the leading infectious cause of death worldwide, and HIV-1 the best recognized risk factor for active TB. This review focuses on immune complex formation; the interplay of type I and II interferon signaling; and T-cell activation in HIV-TB pathogenesis. RECENT FINDINGS: Circulating immune complexes and complement, and Fcγ signaling in whole blood act as early markers of TB disease in HIV-1-infected persons. HIV-1 is associated with a type I interferon response in whole blood, reducing the specificity of TB biomarkers dependent on type I and II interferon genes...
November 2018: Current Opinion in HIV and AIDS
Dao Nguyen Vinh, Dang Thi Minh Ha, Nguyen Thi Hanh, Guy Thwaites, Maciej F Boni, Hannah E Clapham, Nguyen Thuy Thuong Thuong
BACKGROUND: The depletion of CD4 cell is the underlying reason for TB hyper-susceptibility among people with HIV. Consequently, the trend of TB dynamics is usually hidden by the HIV outbreak. METHODS: Here, we aim to evaluate the trend of TB dynamics quantitatively by a simple mathematical model using the known prevalence of hyper-susceptible individuals in the population. In order to estimate the parameters governing transmission we fit this model in a maximum likelihood framework to both reported TB cases and data from samples tested with Interferon Gamma Assay from Ho Chi Minh City - a city with high TB transmission and strong synchronization between HIV/AIDS and TB dynamics...
October 1, 2018: BMC Infectious Diseases
Chidchamai Kewcharoenwong, Satria A Prabowo, Gregory J Bancroft, Helen A Fletcher, Ganjana Lertmemongkolchai
Tuberculosis (TB) is a global public health problem, which is caused by Mycobacterium tuberculosis (Mtb). Type 2 diabetes mellitus (T2DM) is one of the leading predisposing factors for development of TB after HIV/AIDS. Glibenclamide is a widely used anti-diabetic drug in low and middle-income countries where the incidence of TB is very high. In a human macrophage cell line, glibenclamide, a K+ ATP-channel blocker, promoted alternative activation of macrophages by enhancing expression of the M2 marker CD206 during M2 polarization...
2018: Frontiers in Immunology
Chandravali Madan, Kamal Kishore Chopra, Srinath Satyanarayana, Diya Surie, Vineet Chadha, Kuldeep Singh Sachdeva, Ashwani Khanna, Rajesh Deshmukh, Lopamudra Dutta, Amit Namdeo, Ajay Shukla, Karuna Sagili, Lakhbir Singh Chauhan
BACKGROUND: Tuberculosis (TB) patients with human immunodeficiency virus (HIV) co-infection have worse TB treatment outcomes compared to patients with TB alone. The distribution of unfavourable treatment outcomes differs by socio-demographic and clinical characteristics, allowing for early identification of patients at risk. OBJECTIVE: To develop a statistical model that can provide individual probabilities of unfavourable outcomes based on demographic and clinical characteristics of TB-HIV co-infected patients...
2018: PloS One
Bekele Tesfaye, Animut Alebel, Alemu Gebrie, Abriham Zegeye, Cheru Tesema, Bekalu Kassie
BACKGROUND: Tuberculosis and HIV/AIDS are the major public health problems in many parts of the world particularly in resource limited countries like Ethiopia. Although studies have been conducted on the prevalence and associated factors of TB / HIV co-infection in Ethiopia, there is no comprehensive data on the magnitude and risk factors at a national and regional levels. Therefore, this review is aimed to summarize the prevalence of TB /HIV co-infection in Ethiopia using meta-analysis based on a systematic review of published articles & grey literatures...
2018: PloS One
A P Wachinou, G Agodokpessi, A Agbodande, D Affolabi, M Esse, O Adjibode, S Anagonou
OBJECTIVE: To determine the epidemiological, diagnostic and evolutives features of tuberculosis (TB) in older subjects in Benin. PATIENTS AND METHODS: This was a retrospective cohort study of adults TB patients (age≥15 years) who were notified at all the Basic Management Units (BMU) in Benin from January 1st, 2013 to December 31st. Older subjects (age≥60 years) were compared to those less than 60 years named young subjects. The threshold of significance was set at 5%...
September 29, 2018: Revue de Pneumologie Clinique
Zoë M McLaren, Alana Sharp, Elizabeth Brouwer, Ananta Nanoo
Human immunodeficiency virus/Tuberculosis (HIV/TB) coinfection is particularly prevalent in South Africa, where TB has been the leading cause of death for more than a decade. The 2004-2008 national rollout of antiretroviral therapy (ART) provides a unique opportunity to examine the population-level impact of ART on the TB epidemic. We performed longitudinal regression analysis to follow the evolution of TB outcomes before and after the introduction of ART using a large data set from the National Health Laboratory Service...
October 1, 2018: American Journal of Tropical Medicine and Hygiene
A Jokwiro, C Timire, A D Harries, P T Gwinji, A Mulema, K C Takarinda, P T Mafaune, C Sandy
Setting: Manicaland Province, Zimbabwe. Objectives: To compare the utilisation and results of deploying Xpert® MTB/RIF in 13 (one provincial, six district and six rural) hospitals between January and June 2016, when Xpert was recommended only for those with presumptive multidrug-resistant tuberculosis (MDR-TB) and coinfection with human immunodeficiency virus (HIV), and between January and June 2017, when Xpert was recommended for all presumptive TB patients. Design: This was a cross-sectional study. Results: Xpert assays averaged 759 monthly in 2016 and 1430 monthly in 2017 (88% increase)...
September 21, 2018: Public Health Action
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