Infectiousness of Mycobacterium tuberculosis in HIV-1-infected patients with tuberculosis: a prospective study

Espinal, Marcos; Pérez, Eddy; Baéz, Jannette; Henríquez, L. M.; Fernández, K; López, María Teresa Rugeles; Olivo, Pedro; Reingold, Arthur

doi:10.1016/s0140-6736(99)04402-5

Cited by 86 publications

(56 citation statements)

References 8 publications

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“…From a study of the relative risk of TB as a function of CD4 ϩ cell count, we estimate the relative risk of progressive primary TB and endogenous reactivation for each of the four stages of HIV (17). We allow the proportion of progressive primary cases that are infectious, the rate of smear conversion, and the infectiousness of people with HIV to decline with decreasing CD4 ϩ cell count (26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Methodsmentioning

confidence: 99%

The impact of HIV/AIDS on the control of tuberculosis in India

Williams

Granich²,

Chauhan³

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

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Epidemics of HIV͞AIDS have increased the tuberculosis (TB) caseload by five or more times in East Africa and southern Africa. As HIV continues to spread, warnings have been issued of disastrous AIDS and TB epidemics in ''new-wave'' countries, including India, which accounts for 20% of all new TB cases arising in the world each year. Here we investigate whether, in the face of the HIV epidemic, India's Revised National TB Control Program (RNTCP) could halve TB prevalence and death rates in the period 1990 -2015, as specified by the United Nations Millennium Development Goals. Using a mathematical model to capture the spatial and temporal variation in TB and HIV in India, we predict that, without the RNTCP, HIV would increase TB prevalence (by 1%), incidence (by 12%), and mortality rates (by 33%) between 1990 and 2015. With the RNTCP, however, we expect substantial reductions in prevalence (by 68%), incidence (by 41%), and mortality (by 39%) between 1990 and 2015. In India, 29% of adults but 72% of HIV-positive adults live in four large states in the south where, even with the RNTCP, mortality is expected to fall by only 15% between 1990 and 2015. Nationally, the RNTCP should be able to reverse the increases in TB burden due to HIV but, to ensure that TB mortality is reduced by 50% or more by 2015, HIV-infected TB patients should be provided with antiretroviral therapy in addition to the recommended treatment for TB. millenium development ͉ goals ͉ infectious disease control ͉ dynamical simulation model I n many countries of East and southern Africa, tuberculosis (TB) notification rates have increased by five or more times as a result of the HIV epidemic (1-3). If this were to happen in India, which accounts for 20% of the global burden of TB (1), the total number of TB cases in the world would more than double. At present, Ͻ1% of Indian adults are infected with HIV, but that is about five million people (4), second only in number to South Africa (5, 6). It has been suggested that the prevalence of HIV infection in Indian adults could reach 5%, or Ϸ25 million people (7-9), and an HIV epidemic on this scale would have severe consequences for the burden not only of AIDS but also of TB.In 1993, the Government of India launched a pilot project to explore the implementation of the World Health Organization's DOTS strategy for TB control, based on combination chemotherapy (10, 11). In 1998, the Revised National TB Control Program (RNTCP) began to expand DOTS services across India. By the end of 2003, 740 million people had access to DOTS, and a further 10 million were gaining access each month. In DOTS areas in 2003, an estimated 69% of new smear-positive TB cases were detected, and 87% were successfully treated (1). Without the HIV epidemic, the RNTCP might have been expected to reduce TB incidence, prevalence, and mortality rates by Ϸ5% per year (12)(13)(14).In this paper, we use a dynamical simulation model to investigate the impact of the HIV epidemic and the RNTCP DOTS program on TB in India from 1990 to 2015. In p...

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Section: Methodsmentioning

confidence: 99%

The impact of HIV/AIDS on the control of tuberculosis in India

Williams

Granich²,

Chauhan³

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

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“…Co-infected patients are less likely to transmit resistant strains [28] and population-based studies have not found an association between HIV and MDR-TB [27].…”

Section: Hiv and Multidrug-resistant Tbmentioning

confidence: 99%

Tuberculosis–HIV co‐infection: policy and epidemiology in 25 countries in the WHO European region

Lazarus

Olsen²,

Diţiu

et al. 2008

HIV Medicine

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Objectives The aims of this study were to collect and review tuberculosis (TB)–HIV data for Europe and to provide an overview of current health policies addressing co‐infection. Methods We collected reported cases of TB–HIV from the 25 most affected member states of the World Health Organization (WHO) European region. Countries were also asked whether they had implemented health policies covering collaborative TB–HIV activities and what their main achievements, obstacles and needs were in addressing TB–HIV. Results Twenty countries reported registering a total of 6925 TB–HIV cases in 2005. Among TB patients tested, 3.3% were found to be HIV‐positive, up from 2.1% in 2004. The male‐to‐female ratio was 2.7:1. The largest percentage of co‐infections were reported in people aged 25–34 years (47.8%). Recommended TB–HIV policies have been implemented in many of the countries. Conclusions Case‐finding has improved in many countries and the reported incidence of TB–HIV is increasing in the European region, particularly among young adults, although it remains low compared to other parts of the world. Strengthened coordination of existing TB and HIV services is still needed.

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“…The severity of this global medical problem has worsened in recent years due to emergence of drug-resistant Mycobacterium tuberculosis strains (19) and to its association with human immunodeficiency virus (HIV) infection (10). One-third of the world's population is infected by M. tuberculosis.…”

mentioning

confidence: 99%

“…That means that the majority of individuals develop in fact a protective immune response, which seems to include a delayed-type hypersensitivity reaction (4). An unknown proportion of tuberculin skin test-positive individuals infected by M. tuberculosis has a latent infection capable of reactivating in old age or following HIV infection (10). Although the immune system is able to control the infection in most individuals, it is not effective at destroying the mycobacteria utterly (13).…”

mentioning

confidence: 99%

Comparative and Prospective Study of Different Immune Parameters in Healthy Subjects at Risk for Tuberculosis and in Tuberculosis Patients

Portales-Pérez¹,

Baranda

Layseca

et al. 2002

Clin Vaccine Immunol

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It has not been fully elucidated which of the components of the immune response against Mycobacterium tuberculosis is indicative of resistance or susceptibility. The aim of this study was to identify an immune parameter that could be indicative of either resistance or susceptibility to M. tuberculosis infection. We prospectively studied (three determinations, at months 0, 8, and 12) 15 patients with chronic pulmonary tuberculosis and 42 healthy individuals with a recent and frequent contact with tuberculosis patients. Peripheral blood mononuclear cells were stimulated with a whole-protein extract or the 30-kDa antigen of M. tuberculosis for 6 days, and several immune parameters were determined. No consistent differences between tuberculosis patients and healthy controls were detected in most immune parameters studied, including the expression of different activation antigens, cytokine secretion, lymphocyte proliferation, and nitric oxide production. However, the synthesis of tumor necrosis factor alpha, the intracellular detection of gamma interferon, and the apoptosis of monocytes under certain culture conditions tended to show clear-cut differences in cells from patients and controls (P < 0.05 in all cases for most determinations). Nevertheless, when results were analyzed on an individual basis, it was evident that a significant degree of overlapping of values from patients and controls occurred for all parameters studied. We conclude that although the immune parameters tested do not allow the identification of individuals susceptible to M. tuberculosis, the specificity and sensitivity of some of them could be improved through future studies.

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Infectiousness of Mycobacterium tuberculosis in HIV-1-infected patients with tuberculosis: a prospective study

Cited by 86 publications

References 8 publications

The impact of HIV/AIDS on the control of tuberculosis in India

The impact of HIV/AIDS on the control of tuberculosis in India

Tuberculosis–HIV co‐infection: policy and epidemiology in 25 countries in the WHO European region

Comparative and Prospective Study of Different Immune Parameters in Healthy Subjects at Risk for Tuberculosis and in Tuberculosis Patients

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