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Tuberculosis and HIV Coinfection

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https://www.readbyqxmd.com/read/28202799/clonal-complexity-in-mycobacterium-tuberculosis-can-hamper-diagnostic-procedures
#1
Laura Pérez-Lago, Marta Herranz, Yurena Navarro, María Jesús Ruiz Serrano, Pilar Miralles, Emilio Bouza, Darío García-de-Viedma
Clonal complexity is increasingly accepted in Mycobacterium tuberculosis infection, including mixed infections by ≥2 strains, which usually occur in settings with a high burden of tuberculosis and/or a high risk of overexposure to infected patients. Mixed infections can hamper diagnostic procedures: obtaining an accurate antibiogram is difficult when the susceptibility patterns of the strains differ. Here, we show how mixed infections can also prove challenging for other diagnostic procedures, even outside settings where mixed infections are traditionally expected...
February 15, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28185618/tuberculosis-a-world-health-organization-perspective
#2
Giovanni Sotgiu, Giorgia Sulis, Alberto Matteelli
Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. The World Health Organization (WHO) has implemented and scaled-up three important global public health strategies (i.e., DOTS, Stop TB, and End TB) to improve the international scenario. Their epidemiological impact was relevant, as they decreased the number of potential new cases of disease and death. However, the emergence and spread of TB/HIV coinfection and multidrug-resistant TB have hindered the progress towards the elimination of TB by 2050...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28155817/impact-of-the-genexpert-mtb-rif-technology-on-tuberculosis-control
#3
Wendy Susan Stevens, Lesley Scott, Lara Noble, Natasha Gous, Keertan Dheda
Molecular technology revolutionized the diagnosis of tuberculosis (TB) with a paradigm shift to faster, more sensitive, clinically relevant patient care. The most recent molecular leader is the GeneXpert MTB/RIF assay (Xpert) (Cepheid, Sunnyvale, CA), which was endorsed by the World Health Organization with unprecedented speed in December 2010 as the initial diagnostic for detection of HIV-associated TB and for where high rates of drug resistance are suspected. South Africa elected to take an aggressive smear replacement approach to facilitate earlier diagnosis and treatment through the decision to implement the Xpert assay nationally in March 2011, against the backdrop of approximately 6...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28123239/antitubercular-therapy-induced-liver-function-tests-abnormalities-in-human-immunodeficiency-virus-infected-individuals
#4
Pankaj Puri, Navjyot Kaur, Sunny Pathania, Sandeep Kumar, P K Sharma, V K Sashindran
BACKGROUND: Both antitubercular therapy (ATT) and antiretroviral therapy (ART) can cause drug induced liver injury (DILI) in tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection. The aim of this research was to study ATT-induced liver function test (LFT) abnormalities in HIV-infected patients. METHODS: HIV-infected patients diagnosed with TB were evaluated with baseline LFT and CD4 counts. ATT regimen was modified if baseline LFT was significantly abnormal...
January 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28104935/neurotuberculosis-immune-reconstitution-inflammatory-syndrome-in-the-setting-of-hiv-infection-a-case-report-and-review-of-literature
#5
Deepasree Jaganmohan, Sunitha V Chakkalakkoombil, Anjana A Beena, Nagarajan Krishnan
Immune reconstitution inflammatory syndrome (IRIS) is an exaggerated immune response which can occur with various coinfections in human immunodeficiency virus (HIV) infected patients, of which the most commonly implicated in central nervous system (CNS)-IRIS are progressive multifocal leukoencephalopathy (PML), cryptococcosis, and tuberculosis (TB). TB-IRIS is a known complication of pulmonary TB or TB lymphadenitis coinfection in HIV infected patients who are on antituberculosis treatment (ATT) after the initiation of antiretroviral therapy (ART)...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28081036/one-year-mortality-of-hiv-positive-patients-treated-for-rifampicin-and-isoniazid-susceptible-tuberculosis-in-eastern-europe-western-europe-and-latin-america
#6
(no author information available yet)
OBJECTIVES: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. METHODS: One-year mortality of HIV-positive patients with rifampicin/isoniazid-susceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study...
January 28, 2017: AIDS
https://www.readbyqxmd.com/read/28043602/screening-new-tuberculosis-patients-in-mali-for-rifampicin-resistance-at-2months
#7
Bassirou Diarra, Aissata B Cissé, Ousmane Kodio, Moumine Sanogo, Bocar Baya, Antieme C G Togo, Amadou Somboro, Mohamed Tolofoudié, Boureima Degoga, Marie Laure Keita, Fatimata Diallo, Natacha Nguiakam, Gagni Coulibaly, Sidy Bane, Yeya Dit Sadio Sarro, Seydou Doumbia, Robert Leo Murphy, Souleymane Diallo, Bouke C Dejong
OBJECTIVE/BACKGROUND: The recent call for universal drug susceptibility testing (DST) for all tuberculosis (TB) patients will be difficult to meet in settings where Xpert rollout is limited, such as low prevalence of HIV and Multi-drug Resistant Tuberculosis (MDR) settings. As recommended by World Health Organization (WHO) guidelines, the success of TB treatment is measured by Ziehl-Neelsen (ZN) microscopy or auramine-rhodamine fluorescent microscopy (FM) on sputum, in which conversion to negative smear at 2months (M) is an important predictor of treatment success, defined as a negative smear at 5M...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043600/benefits-and-challenges-of-molecular-diagnostics-for-childhood-tuberculosis
#8
Cristina Gutierrez
Expanding tuberculosis (TB)-diagnostic services, including access to rapid tests, is a World Health Organization (WHO) strategy to accelerate progress toward ending TB. Faster and more sensitive molecular tests capable of diagnosing TB and drug-resistant TB have the technical capacity to address limitations associated with smears and cultures by increasing accuracy and shortening turnaround times as compared with those of these conventional laboratory methods. Nucleic acid amplification assays used to detect and analyze Mycobacterium tuberculosis (MTB)-complex nucleic acids can be used directly on specimens from patients suspected of having TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043543/investigation-of-urine-lipoarabinomannan-in-human-immunodeficiency-virus-patients-with-or-without-coinfection-with-tuberculosis-in-iran
#9
Payam Tabarsi, Majid Marjani, Afshin Moniri, Parissa Farnia, Mehdi Kazempour Dizaji, John Garssen, Ian M Adcock, Esmaeil Mortaz
OBJECTIVE/BACKGROUND: Tuberculosis (TB) remains the leading cause of AIDS-related deaths among adults in countries with resource limitations. The emergence of the Xpert MTB/RIF rapid molecular assay and its subsequent World Health Organization endorsement in 2010 transformed the TB-diagnostic landscape. Xpert provided diagnostic accuracy that was far superior to that of the sputum-smear microscopy test previously used. The detection of mycobacterial lipoarabinomannan (LAM) antigen in urine has emerged as a potential point-of-care test for TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043526/hiv-and-tuberculosis-trends-and-survival-of-coinfection-in-a-referral-center-in-tehran-a-12-year-study
#10
Parvaneh Baghaei, Payam Tabarsi, Syna Jabehdari, Majid Marjani, Afshin Moniri, Parissa Farnia, Ali Akbar Velayati
OBJECTIVE/BACKGROUND: The risk of mortality and morbidity among tuberculosis (TB) and human immunodeficiency virus (HIV) coinfected patients is significantly higher than that of patients infected with TB alone. The aim of this study was to evaluate the survival of TB-HIV patients in a TB-referral center during a 10-year follow-up. METHODS: All TB-HIV patients in our referral center were enrolled in the study from 2003 to 2014, and patients were divided into two groups: HIV-TB patients without a history of TB treatment (new cases of TB) and HIV-TB patients with a history of TB treatment...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28017825/diagnosis-of-pulmonary-tuberculosis-and-assessment-of-treatment-response-through-analyses-of-volatile-compound-patterns-in-exhaled-breath-samples
#11
Nicola M Zetola, Chawangwa Modongo, Ogopotse Matsiri, Tsaone Tamuhla, Bontle Mbongwe, Keikantse Matlhagela, Enoch Sepako, Alexandro Catini, Giorgio Sirugo, Eugenio Martinelli, Roberto Paolesse, Corrado Di Natale
OBJECTIVES: We determined the performance of a sensor array (an electronic nose) made of 8 metalloporphyrins coated quartz microbalances sensors for the diagnosis and prognosis of pulmonary tuberculosis (TB) using exhaled breath samples. METHODS: TB cases and healthy controls were prospectively enrolled. Signals from volatile organic compounds (VOCs) in breath samples were measured at days 0, 2, 7, 14, and 30 of TB therapy and correlated with clinical and microbiological measurements...
December 22, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27960209/community-acquired-pneumonia-in-sub-saharan-africa
#12
Stephen J Aston, Jamie Rylance
Community-acquired pneumonia (CAP) in sub-Saharan Africa is a common cause of adult hospitalization and is associated with significant mortality. Human immunodeficiency virus (HIV) prevalence in the region leads to differences in CAP epidemiology compared with most high-income settings: patients are younger, and coinfection with tuberculosis and opportunistic infections is common and difficult to diagnose. Resource limitations affect the availability of medical expertise as well as radiological and laboratory diagnostic services...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27936379/clinical-and-epidemiological-characteristics-associated-with-unfavorable-tuberculosis-treatment-outcomes-in-tb-hiv-co-infected-patients-in-brazil-a-hierarchical-polytomous-analysis
#13
Thiago Nascimento do Prado, Jayant V Rajan, Angélica Espinosa Miranda, Elias Dos Santos Dias, Lorrayne Beliqui Cosme, Lia Gonçalves Possuelo, Mauro N Sanchez, Jonathan E Golub, Lee W Riley, Ethel Leonor Maciel
BACKGROUND: TB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil. METHODS: TB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB)...
December 6, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27928075/detecting-mutations-in-the-mycobacterium-tuberculosis-pyrazinamidase-gene-pnca-to-improve-infection-control-and-decrease-drug-resistance-rates-in-human-immunodeficiency-virus-coinfection
#14
Matthew Z Dudley, Patricia Sheen, Robert H Gilman, Eduardo Ticona, Jon S Friedland, Daniela E Kirwan, Luz Caviedes, Richard Rodriguez, Lilia Z Cabrera, Jorge Coronel, Louis Grandjean, David A J Moore, Carlton A Evans, Luz Huaroto, Víctor Chávez-Pérez, Mirko Zimic
Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)-positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZA resistance associated with mutations in the nicotinamidase/pyrazinamidase coding gene, pncA, is increasing. A total of 794 patient isolates obtained from four sites in Lima, Peru, underwent spoligotyping and drug resistance testing...
December 7, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27855070/pharmacokinetics-of-the-first-line-antituberculosis-drugs-in-ghanaian-children-with-tuberculosis-with-or-without-hiv-coinfection
#15
Sampson Antwi, Hongmei Yang, Anthony Enimil, Anima M Sarfo, Fizza S Gillani, Daniel Ansong, Albert Dompreh, Antoinette Orstin, Theresa Opoku, Dennis Bosomtwe, Lubbe Wiesner, Jennifer Norman, Charles A Peloquin, Awewura Kwara
Although human immunodeficiency virus (HIV) coinfection is the most important risk factor for a poor antituberculosis (anti-TB) treatment response, its effect on the pharmacokinetics of the first-line drugs in children is understudied. This study examined the pharmacokinetics of the four first-line anti-TB drugs in children with TB with and without HIV coinfection. Ghanaian children with TB on isoniazid, rifampin, pyrazinamide, and ethambutol for at least 4 weeks had blood samples collected predose and at 1, 2, 4, and 8 hours postdose...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27828731/the-pharmacological-challenges-of-treating-tuberculosis-and-hiv-coinfections
#16
Eric F Egelund, Lori Dupree, Emily Huesgen, Charles A Peloquin
Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis...
February 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27776589/provider-perspectives-on-drug-resistant-tuberculosis-and-human-immunodeficiency-virus-care-in-south-africa-a-qualitative-case-study
#17
A Daftary, N Padayatchi
OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss...
November 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27754538/hiv-testing-antiretroviral-therapy-and-treatment-outcomes-in-new-cases-of-tuberculosis-in-brazil-2011
#18
Ana Torrens, Patricia Bartholomay, Silvano Silva, Mohammed Khogali, Kristien Verdonck, Karen Bissell
Objective To assess the implementation of HIV-related interventions for patients with tuberculosis (TB), as well as TB treatment outcomes in patients coinfected with HIV in Brazil in 2011. Methods This was a cross-sectional, operational research study of HIV-related interventions among TB cases and the sociodemographic and clinical characteristics of TB-HIV coinfected patients. It also used a retrospective cohort design to determine the association between antiretroviral therapy (ART) and favorable TB treatment outcomes...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27754518/determinants-of-tuberculosis-in-countries-of-latin-america-and-the-caribbean
#19
Gustavo Bergonzoli, Luis G Castellanos, Rodolfo Rodríguez, Lina María Garcia
Objectives To explore the relationships among social, economic, environmental, and health services determinants of tuberculosis (TB) morbidity and mortality, and to identify the mechanisms that mediate such associations in countries of Latin America and the Caribbean (LAC). Methods This was an ecological study of 26 LAC countries that had accurate data available on 38 selected variables for the year 2010. The countries represented 99% of the TB burden in LAC. Multivariate linear regression was used to identify associations among determinants of health and TB morbidity and mortality...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27746182/hiv-interferes-with-mycobacterium-tuberculosis-antigen-presentation-in-human-dendritic-cells
#20
Susmita K Singh, Anna-Maria Andersson, Rada Ellegård, Cecilia S Lindestam Arlehamn, Alessandro Sette, Marie Larsson, Olle Stendahl, Robert Blomgran
HIV coinfection is the most prominent risk factor for progression of Mycobacterium tuberculosis (Mtb) infection into active tuberculosis (TB) disease. The mechanisms behind the increased transition from latent to active TB in coinfected individuals have not been well elucidated at the cellular level. We hypothesized that HIV infection contributes to Mtb pathogenesis by interfering with the dendritic cell (DC)-mediated immune control. Mtb-antigen processing and presentation are key events in the immune response against TB...
October 13, 2016: American Journal of Pathology
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