HIV-Associated TB Syndemic: A Growing Clinical Challenge Worldwide

Abstract

The association of tuberculosis (TB) with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome over the past several years has become an emerging syndemic. Approximately 10% of people living with HIV (PLHIV) with latent TB infection will develop active TB disease each year. In this review, we highlight that this phenomenon is not limited to high endemic regions, such as Afro-Asian nations, but globalization/migration is causing increased case detection even in developed nations, such as the United States. Active screening should be performed for TB in PLHIV. A high degree of clinical suspicion for TB is warranted in PLHIV presenting with fever, cough, and unintentional weight loss. HIV–Mycobacterium tuberculosis (MTB) coinfection is often paucibacillary, precluding diagnosis by conventional diagnostics and/or smear microscopy/culture. Improved detection of pulmonary and extrapulmonary TB is now possible by incorporation of the GeneXPERT MTB/RIF assay (Cepheid Inc., Sunnyvale, CA, USA). The World Health Organization recommends instituting immediate therapy for MTB, in conjunction with ongoing or newly introduced anti-retroviral therapy. Vigilance is required to detect drug-induced organ injuries, and early-treatment-induced immune reconstitution inflammatory syndrome. Collaborating MTB and HIV activities in concentrated HIV epidemic settings should become a high public health priority.

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students

“…The correlation between HIV and TB has been strongly characterized in research literature, evidencing that approximately 10% of people with HIV and latent TB infections will develop active TB each year. [27] Developing cities, such as Bandung, Indonesia, are especially prone to TB co-infections due to the high prevalence of HIV. [12,13,28] Some studies recommend the use of ultrasound as a supplementary diagnostic tool in the diagnosis of TB in HIV infected patients, particularly in regions with a high prevalence of TB and HIV coinfections.…”

Vulval Tuberculosis: The Histomorphological Spectrum in Patients with HIV Co-Infection and AIDS

“…The Human Immunodeficiency Virus (HIV) and MTb coinfective partnership is an emerging pandemic in resource-constrained developing and developed nations [1]. The 2013 World Health Organization (WHO) report informed that 14.8% (0.8 million) of the 5.4 million new cases of tuberculosis (TB) were extrapulmonary in location [2].…”

“…The clinicopathological profile of FGT TB and HIV co-infection, in general, is reported even less frequently and the histopathological spectrum in the vulval setting remains undescribed, to date [12]. Because of the burden of TB and the TB/HIV co-morbid partnership worldwide [1], it is pertinent that not only the microscopic morphological familiarity of TB in this location, but also heightened recognition of overlapping features with other vulval infections [13][14][15], are recognized, for accurate diagnosis and effective patient management.…”

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Epidemiological Changes in the World and Turkey

“…Hastalığın bilindiği 35 yıl içinde, HIV/AIDS'nin fırsatçı enfeksiyonlarla ilişkisinin, belli davranış modellerine sahip insan topluluklarında ani yayılmasının, bilinen epidemiyolojik terimler kullanılarak açıklanması mümkün olmamıştır. Günümüzde HIV/AIDS; söz konusu hastalıklar ya da durumlar ve aralarındaki sinerjistik bağlantılarla bir sindemi modeli olarak kabul edilmekte ve hastalığın ve yayılımının kontrolünün çok faktörlü olduğu konusunda oluşan fikir birliği yol gösterici olmaktadır (1)(2)(3)(4).…”