Prevention of tuberculosis in Bacille Calmette–Guérin-primed, HIV-infected adults boosted with an inactivated whole-cell mycobacterial vaccine

Reyn, C. Fordham von; Mtei, Lillian; Arbeit, Robert D.; Waddell, Richard; Cole, Bernard F.; MacKenzie, Todd A.; Matee, Mecky; Bakari, Muhammad; Tvaroha, Susan; Adams, Lisa V.; Horsburgh, C. Robert; Pallangyo, Kisali

doi:10.1097/qad.0b013e3283350f1b

Cited by 203 publications

(151 citation statements)

References 51 publications

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“…Detailed clinical and laboratory data were available for HIV-infected enrolled DarDar subjects who reached a tuberculosis endpoint: baseline CD4 count, HIV viral load, TST status, and history of tuberculosis (30). Screened subjects with tuberculosis at baseline were known to be HIV infected, but no other clinical data were available.…”

Section: Isolatesmentioning

confidence: 99%

“…During the DarDar Vaccine Trial in Tanzania, we collected isolates of M. tuberculosis from patients with HIV infection, as well as community controls, and performed IS6110 typing, spoligotyping, and drug susceptibility testing (30). These data were analyzed to determine the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families.…”

mentioning

confidence: 99%

“…These data were analyzed to determine the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families. (30). We collected M. tuberculosis isolates from subjects screened for or enrolled in the trial which included (i) baseline isolates from 2,960 HIV-infected subjects screened and deemed ineligible for the trial and (ii) endpoint isolates at the time of a tuberculosis episode from 2,013 HIV-infected subjects enrolled in the trial and monitored prospectively for the development of tuberculosis.…”

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confidence: 99%

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Molecular Epidemiology of HIV-Associated Tuberculosis in Dar es Salaam, Tanzania: Strain Predominance, Clustering, and Polyclonal Disease

Adams

Kreiswirth²,

Arbeit

et al. 2012

J Clin Microbiol

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g Molecular typing of Mycobacterium tuberculosis can be used to elucidate the epidemiology of tuberculosis, including the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families. We performed IS6110 typing and spoligotyping on M. tuberculosis strains isolated from HIV-infected subjects at baseline or during follow-up in the DarDar Trial in Tanzania and on selected community isolates. Clustering occurred in 203 (74%) of 275 subjects: 124 (80%) of 155 HIV-infected subjects with baseline isolates, 56 (69%) of 81 HIV-infected subjects with endpoint isolates, and 23 (59%) of 39 community controls. Overall, 113 (41%) subjects had an isolate representing the East Indian "GD" family. The rate of clustering was similar among vaccine and placebo recipients and among subjects with or without cellular immune responses to mycobacterial antigens. Polyclonal disease was detected in 6 (43%) of 14 patients with multiple specimens typed. Most cases of HIV-associated tuberculosis among subjects from this study in Dar es Salaam resulted from recently acquired infection. Polyclonal infection was detected and isolates representing the East Indian GD strain family were the most common.

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Section: Isolatesmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Molecular Epidemiology of HIV-Associated Tuberculosis in Dar es Salaam, Tanzania: Strain Predominance, Clustering, and Polyclonal Disease

Adams

Kreiswirth²,

Arbeit

et al. 2012

J Clin Microbiol

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“…Few innovations have gone into post exposure vaccines. Mycobacterium vaccae (derived from heat killed environmental saprophytes) and semi purified mycobacterium fragments RUTI are among the most promising (Vilaplana C et al 2010, Von Reyn CF et al 2010. These vaccines can be used alongside chemotherapy that eliminates the active organisms while the vaccine elicited immune response mops the remaining pathogens through the strong immune response so elicited …”

Section: Tb Vaccinesmentioning

confidence: 99%

Advances in the Diagnosis, Treatment and Control of HIV Associated Tuberculosis

Kirenga¹,

Chanda²,

Muwonge³

et al. 2012

African Journal of Infectious Diseases

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SummaryThere has been an increase in the number of published tuberculosis/HIV (TB/HIV) research findings in recent times. The potential impact of these findings on routine care has informed this review which aims at discussing current concepts and practices underpinning TB/HIV care and control. Any HIV infected person with a cough of any duration is currently considered a TB suspect. Preliminary results also show that the diagnostic yield of same day sputum samples (front loading) is comparable to two-day samples. Laboratory diagnosis is shifting from Ziehl-Neelsen (ZN) smear microscopy and solid culture to fluorescent microscopy, molecular tests and liquid culture. Concomitant TB/HIV therapy improves survival and WHO has recommended ART for all TB/HIV patients. Unless CD4 cell counts are less than 50 cells/µl, ART can be deferred until end of intensive phase. Evidence of survival benefit at high CD4 cell counts is still lacking. New TB drugs and treatment shortening studies are underway but so far no new TB drugs has been added to the current arsenal and treatment duration still remains six months or more. WHO has recommended the 3Is (intensified TB case finding, isoniazid prophylaxis and infection control) for TB/HIV control in addition to effective therapy, Antiretroviral therapy and TB vaccines. There has been immense progress in TB/HIV research, however optimal management of HIV-Infected TB patients, will require further research and appropriate translation of emerging evidence to policy and practice. IntroductionThe burden of tuberculosis (TB) among human immunodeficiency virus (HIV) infected persons continues to represent a major public health problem. Of the 9.4 million new TB cases reported in 2009, 1.1 million were HIV infected of which 380, 000 died (WHO Global Tuberculosis control report, 2010). Antiretroviral therapy (ART) reduces person and population risk of TB by 90% and 60% respectively (Lawn S et al., 2005, Badri et al., 2002. Unfortunately only 37% of TB/HIV patients who qualified to receive ART were initiated on ART in 2009 (WHO Global Tuberculosis control report, 2010). There has been an increase in basic, clinical and public health TB/HIV research, shedding new light on diagnosis, treatment and control of TB/HIV; hence those involved in the field of TB/HIV need to constantly update their knowledge in this field. The purpose of this review is to describe, discuss and summarize current concepts and practices in the diagnosis, treatment and control of HIV associated tuberculosis. Diagnosis of HIV associated tuberculosisTB symptoms: One of the major advances in the clinical diagnosis of TB/HIV has been the demonstration in number of studies that TB/HIV patients with cough should be tested for TB irrespective of the duration of the cough (Kevin et al., 2010), Ngadaya et al., 2009). In a study that evaluated the performance of different combination of TB symptoms, it was found that the best symptom combination included two predictors; fever of any duration in the previous 4 weeks plus cough of a...

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“…Adjunct immunotherapy, which includes host-directed therapies with immunoadjuvants [123][124][125], recombinant cytokines [126][127][128] or therapeutic vaccinations [128][129][130][131][132][133][134][135][136][137][138], should be further explored to possibly improve the treatment outcome of drug-resistant TB, especially difficult forms of MDR/XDR-TB [139].…”

Section: Future Outlookmentioning

confidence: 99%

Novel drugs against tuberculosis: a clinician's perspective

et al. 2014

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The United Nations Millennium Development Goal of reversing the global spread of tuberculosis by 2015 has been offset by the rampant re-emergence of drug-resistant tuberculosis, in particular fluoroquinolone-resistant multidrug-resistant and extensively drug-resistant tuberculosis. After decades of quiescence in the development of antituberculosis medications, bedaquiline and delamanid have been conditionally approved for the treatment of drug-resistant tuberculosis, while several other novel compounds (AZD5847, PA-824, SQ109 and sutezolid) have been evaluated in phase II clinical trials. Before novel drugs can find their place in the battle against drug-resistant tuberculosis, linezolid has been compassionately used with success in the treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis. This review largely discusses six novel drugs that have been evaluated in phase II and III clinical trials, with focus on the clinical evidence for efficacy and safety, potential drug interactions, and prospect for using multiple novel drugs in new regimens. @ERSpublications A review of the efficacy, safety, and potential of new drugs to improve TB therapy from the perspective of clinicians

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Prevention of tuberculosis in Bacille Calmette–Guérin-primed, HIV-infected adults boosted with an inactivated whole-cell mycobacterial vaccine

Cited by 203 publications

References 51 publications

Molecular Epidemiology of HIV-Associated Tuberculosis in Dar es Salaam, Tanzania: Strain Predominance, Clustering, and Polyclonal Disease

Molecular Epidemiology of HIV-Associated Tuberculosis in Dar es Salaam, Tanzania: Strain Predominance, Clustering, and Polyclonal Disease

Advances in the Diagnosis, Treatment and Control of HIV Associated Tuberculosis

Novel drugs against tuberculosis: a clinician's perspective

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