HIV/AIDS: Research and Palliative Care (Jan 2020)
Drug-Resistant Tuberculosis and HIV Infection: Current Perspectives
Abstract
Abhijeet Singh, 1 Rajendra Prasad, 1, 2 Viswesvaran Balasubramanian, 1 Nikhil Gupta 3 1Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi 110007, India; 2Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh 226003, India; 3Department of Internal Medicine, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh 226010, IndiaCorrespondence: Rajendra PrasadDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi 110007, IndiaTel +91 9415 021 590Email [email protected]: 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: drug-resistant, HIV, multidrug-resistant, extensively drug-resistant, tuberculosis
