Challenges and opportunities to prevent tuberculosis in people living with HIV in low-income countries

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
A D HarriesP I Fujiwara

Abstract

People living with the human immunodeficiency virus (HIV) (PLHIV) are at high risk for tuberculosis (TB), and TB is a major cause of death in PLHIV. Preventing TB in PLHIV is therefore a key priority. Early initiation of antiretroviral therapy (ART) in asymptomatic PLHIV has a potent TB preventive effect, with even more benefits in those with advanced immunodeficiency. Applying the most recent World Health Organization recommendations that all PLHIV initiate ART regardless of clinical stage or CD4 cell count could provide a considerable TB preventive benefit at the population level in high HIV prevalence settings. Preventive therapy can treat tuberculous infection and prevent new infections during the course of treatment. It is now established that isoniazid preventive therapy (IPT) combined with ART among PLHIV significantly reduces the risk of TB and mortality compared with ART alone, and therefore has huge potential benefits for millions of sufferers. However, despite the evidence, this intervention is not implemented in most low-income countries with high burdens of HIV-associated TB. HIV and TB programme commitment, integration of services, appropriate screening procedures for excluding active TB, reliable drug supplies, p...Continue Reading

Citations

Sep 13, 2019·International Journal of Mycobacteriology·Adeboye AzeezJames Ndege
Jan 9, 2020·Journal of the International AIDS Society·Lucia González FernándezSusan Swindells
Jul 29, 2021·The International Journal of Health Planning and Management·Fatima Muhammad Asad KhanMohammad Yasir Essar
Dec 19, 2021·Annals of Clinical Microbiology and Antimicrobials·Darrel Ornelle Elion AssianaFrancine Ntoumi

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