Drug-Resistant Tuberculosis and HIV Infection: Current Perspectives

Abhijeet Singh; Rajendra Prasad; Viswesvaran Balasubramanian; Nikhil Gupta

doi:10.2147/HIV.S193059

Drug-Resistant Tuberculosis and HIV Infection: Current Perspectives

HIV AIDS (Auckl). 2020 Jan 13:12:9-31. doi: 10.2147/HIV.S193059. eCollection 2020.

Authors

Abhijeet Singh¹, Rajendra Prasad^{1

2}, Viswesvaran Balasubramanian¹, Nikhil Gupta³

Affiliations

¹ Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi 110007, India.
² Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh 226003, India.
³ Department of Internal Medicine, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh 226010, India.

Abstract

Drug-resistant tuberculosis (DR-TB), including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), is considered a potential obstacle for elimination of TB globally. HIV coinfection with M/XDR-TB further complicates the scenario, and is a potential threat with challenging management. Reports have shown poor outcomes and alarmingly high mortality rates among people living with HIV (PLHIV) coinfected with M/XDR-TB. This coinfection is also responsible for all forms of M/XDR-TB epidemics or outbreaks. Better outcomes with reductions in mortality have been reported with concomitant treatment containing antiretroviral drugs for the HIV component and antitubercular drugs for the DR-TB component. Early and rapid diagnosis with genotypic tests, prompt treatment with appropriate regimens based on drug-susceptibility testing, preference for shorter regimens fortified with newer drugs, a patient-centric approach, and strong infection-control measures are all essential components in the management of M/XDR-TB in people living with HIV.

Keywords: HIV; drug-resistant; extensively drug-resistant; multidrug-resistant; tuberculosis.

Publication types

Review