Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review

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dc.contributor.authorLawn, Stephenen_ZA
dc.contributor.authorMeintjes, Graemeen_ZA
dc.contributor.authorMcIlleron, Helenen_ZA
dc.contributor.authorHarries, Anthonyen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.date.accessioned2015-10-28T06:50:57Z
dc.date.available2015-10-28T06:50:57Z
dc.date.issued2013en_ZA
dc.description.abstractThe HIV-associated tuberculosis (TB) epidemic remains a huge challenge to public health in resource-limited settings. Reducing the nearly 0.5 million deaths that result each year has been identified as a key priority. Major progress has been made over the past 10 years in defining appropriate strategies and policy guidelines for early diagnosis and effective case management. Ascertainment of cases has been improved through a twofold strategy of provider-initiated HIV testing and counseling in TB patients and intensified TB case finding among those living with HIV. Outcomes of rifampicin-based TB treatment are greatly enhanced by concurrent co-trimoxazole prophylaxis and antiretroviral therapy (ART). ART reduces mortality across a spectrum of CD4 counts and randomized controlled trials have defined the optimum time to start ART. Good outcomes can be achieved when combining TB treatment with first-line ART, but use with second-line ART remains challenging due to pharmacokinetic drug interactions and cotoxicity. We review the frequency and spectrum of adverse drug reactions and immune reconstitution inflammatory syndrome (IRIS) resulting from combined treatment, and highlight the challenges of managing HIV-associated drug-resistant TB.en_ZA
dc.identifier.apacitationLawn, S., Meintjes, G., McIlleron, H., Harries, A., & Wood, R. (2013). Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review. <i>BMC Medicine</i>, http://hdl.handle.net/11427/14431en_ZA
dc.identifier.chicagocitationLawn, Stephen, Graeme Meintjes, Helen McIlleron, Anthony Harries, and Robin Wood "Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review." <i>BMC Medicine</i> (2013) http://hdl.handle.net/11427/14431en_ZA
dc.identifier.citationLawn, S. D., Meintjes, G., McIlleron, H., Harries, A. D., & Wood, R. (2013). Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review. BMC medicine, 11(1), 253.en_ZA
dc.identifier.ris TY - Journal Article AU - Lawn, Stephen AU - Meintjes, Graeme AU - McIlleron, Helen AU - Harries, Anthony AU - Wood, Robin AB - The HIV-associated tuberculosis (TB) epidemic remains a huge challenge to public health in resource-limited settings. Reducing the nearly 0.5 million deaths that result each year has been identified as a key priority. Major progress has been made over the past 10 years in defining appropriate strategies and policy guidelines for early diagnosis and effective case management. Ascertainment of cases has been improved through a twofold strategy of provider-initiated HIV testing and counseling in TB patients and intensified TB case finding among those living with HIV. Outcomes of rifampicin-based TB treatment are greatly enhanced by concurrent co-trimoxazole prophylaxis and antiretroviral therapy (ART). ART reduces mortality across a spectrum of CD4 counts and randomized controlled trials have defined the optimum time to start ART. Good outcomes can be achieved when combining TB treatment with first-line ART, but use with second-line ART remains challenging due to pharmacokinetic drug interactions and cotoxicity. We review the frequency and spectrum of adverse drug reactions and immune reconstitution inflammatory syndrome (IRIS) resulting from combined treatment, and highlight the challenges of managing HIV-associated drug-resistant TB. DA - 2013 DB - OpenUCT DO - 10.1186/1741-7015-11-253 DP - University of Cape Town J1 - BMC Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review TI - Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review UR - http://hdl.handle.net/11427/14431 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14431
dc.identifier.urihttp://dx.doi.org/10.1186/1741-7015-11-253
dc.identifier.vancouvercitationLawn S, Meintjes G, McIlleron H, Harries A, Wood R. Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review. BMC Medicine. 2013; http://hdl.handle.net/11427/14431.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2013 Lawn et al.; licensee BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Medicineen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcmed/en_ZA
dc.subject.otherHIV/AIDSen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherDrug Resistanceen_ZA
dc.subject.otherHIV Infectionsen_ZA
dc.subject.otherAntiretroviral Therapyen_ZA
dc.subject.otherHealth Servicesen_ZA
dc.titleManagement of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art reviewen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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