New management approaches to tuberculosis in people living with HIV

Mhango, David V, Mzinza, David T, Jambo, Kondwani ORCID: https://orcid.org/0000-0002-3195-2210 and Mwandumba, Henry ORCID: https://orcid.org/0000-0003-4470-3608 (2021) 'New management approaches to tuberculosis in people living with HIV'. Current Opinion in Infectious Diseases, Vol 34, Issue 1, pp. 25-33.

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Abstract

PURPOSE OF REVIEW
People living with HIV (PLWH) are commonly coinfected with Mycobacterium tuberculosis, particularly in high-transmission resource-limited regions. Despite expanded access to antiretroviral therapy and tuberculosis (TB) treatment, TB remains the leading cause of death among PLWH. This review discusses recent advances in the management of TB in PLWH and examines emerging therapeutic approaches to improve outcomes of HIV-associated TB.

RECENT FINDINGS
Three recent key developments have transformed the management of HIV-associated TB. First, the scaling-up of rapid point-of-care urine-based tests for screening and diagnosis of TB in PLWH has facilitated early case detection and treatment. Second, increasing the availability of potent new and repurposed drugs to treat drug-resistant TB has generated optimism about the treatment and outcome of multidrug-resistant and extensively drug-resistant TB. Third, expanded access to the integrase inhibitor dolutegravir to treat HIV in resource-limited regions has simplified the management of TB/HIV coinfected patients and minimized serious adverse events.

SUMMARY
While it is unequivocal that substantial progress has been made in early detection and treatment of HIV-associated TB, significant therapeutic challenges persist. To optimize the management and outcomes of TB in HIV, therapeutic approaches that target the pathogen as well as enhance the host response should be explored.

Item Type:	Article
Subjects:	WC Communicable Diseases > Infection. Bacterial Infections > Other Bacterial Infections. Zoonotic Bacterial Infections > WC 302 Actinomycetales infections. Mycobacterium infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI):	https://doi.org/10.1097/QCO.0000000000000704
Depositing User:	Julie Franco
Date Deposited:	07 Apr 2021 09:45
Last Modified:	10 Dec 2021 02:02
URI:	https://archive.lstmed.ac.uk/id/eprint/17451

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