Tuberculosis-HIV Co-Infection: Progress and Challenges After Two Decades of Global Antiretroviral Treatment Roll-Out

Emilio Letang; Jayne Ellis; Kogieleum Naidoo; Esther C Casas; Paquita Sánchez; Razia Hassan-Moosa; Fiona Cresswell; Jose M Miró; Alberto L García-Basteiro

doi:10.1016/j.arbr.2019.11.013

Tuberculosis-HIV Co-Infection: Progress and Challenges After Two Decades of Global Antiretroviral Treatment Roll-Out

Arch Bronconeumol. 2020 Jul;56(7):446-454. doi: 10.1016/j.arbr.2019.11.013.

Authors

Emilio Letang¹, Jayne Ellis², Kogieleum Naidoo³, Esther C Casas⁴, Paquita Sánchez⁵, Razia Hassan-Moosa³, Fiona Cresswell⁶, Jose M Miró⁷, Alberto L García-Basteiro⁸

Affiliations

¹ ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain. Electronic address: emili.letang@isglobal.org.
² Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Hospital for Tropical Diseases, University College London, London, UK.
³ Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, South Africa.
⁴ Southern Africa Medical Unit, Médecins sans Frontières, Cape Town, South Africa.
⁵ Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain.
⁶ Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK; MRC-UVRI-London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
⁷ Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
⁸ ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.

PMID: 35373756
DOI: 10.1016/j.arbr.2019.11.013

Abstract

Despite wide antiretroviral scale-up during the past two decades resulting in declining new infections and mortality globally, HIV-associated tuberculosis remains as a major public health concern. Tuberculosis is the leading HIV-associated opportunistic infection and the main cause of death globally and, particularly, in resource-limited settings. Several challenges exist regarding diagnosis, global implementation of latent tuberculosis treatment, management of active tuberculosis, delivery of optimal patient-centered TB and HIV prevention and care in high burden countries. In this article we review the advances on pathogenesis, diagnosis, and treatment after nearly two decades of global roll-out of antiretroviral therapy and discuss the current challenges for the global control of tuberculosis-HIV co-infection.

Keywords: ART; Diagnosis; Diagnóstico; HIV/AIDS; Implementation challenges; Pathogenesis; Patogénesis; Resource-limited settings; Retos en implementación; Situaciones de recursos limitados; TARV; Tratamiento; Treatment; Tuberculosis; VIH/SIDA.

Publication types

Review