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

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dc.contributor.authorLawn, Stephen D
dc.contributor.authorMeintjes, Graeme
dc.contributor.authorMcIlleron, Helen
dc.contributor.authorHarries, Anthony D
dc.contributor.authorWood, Robin
dc.date.accessioned2016-07-21T13:00:58Z
dc.date.available2016-07-21T13:00:58Z
dc.date.issued2013-12-02
dc.date.updated2016-07-19T18:02:20Z
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. 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. <i>BMC medicine</i>, http://hdl.handle.net/11427/20570en_ZA
dc.identifier.chicagocitationLawn, Stephen D, Graeme Meintjes, Helen McIlleron, Anthony D 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/11427/20570en_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.issn1741-7015en_ZA
dc.identifier.ris TY - Journal Article AU - Lawn, Stephen D AU - Meintjes, Graeme AU - McIlleron, Helen AU - Harries, Anthony D 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 - 2013-12-02 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 SM - 1741-7015 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/11427/20570 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/1741-7015-11-253
dc.identifier.urihttp://hdl.handle.net/11427/20570
dc.identifier.vancouvercitationLawn SD, Meintjes G, McIlleron H, Harries AD, Wood R. Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review. BMC medicine. 2013; http://hdl.handle.net/11427/20570.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderLawn et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC medicineen_ZA
dc.source.urihttp://bmcmedicine.biomedcentral.com/
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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