Tuberculosis and AIDS: treatment, prophylaxis, and public health issues.

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Tuberculosis and AIDS: treatment, prophylaxis, and public health issues.

Int Conf AIDS. 1993 Jun 6-11;9(1):10 (abstract no. PS-04-3). Unique Identifier : AIDSLINE MED/93333219
De Cock KM; Kassim S; Ackah A; Digbeu H; Abouya L; Coulibaly D; Coulibaly IM; Projet RETRO-CI, Abidjan, Cote d'Ivoire.

Abstract: OBJECTIVES: To review the public health impact of HIV-associated tuberculosis (TB), and its diagnosis, therapy, and prophylaxis. CONTENTS OF LECTURE: Evidence for association between HIV infection and TB (HIV/TB) includes clinical observations and epidemiological data. The greatest public health impact of HIV/TB is in sub-Saharan Africa, where rates of coinfection with HIV and Mycobacterium tuberculosis are highest and TB is the most common cause of death in AIDS patients. Reactivation of prior tuberculous infection probably accounts for most HIV-associated TB cases, but rapid progression of recent tuberculous infection in HIV-positive persons also occurs. The importance of reinfection with M tuberculosis, and the influence of TB on the natural history of HIV infection, are debated. Diagnosis of HIV-associated TB is handicapped by the frequency of sputum-smear-negative disease and atypical radiological features. Clinical presentation of TB varies by CD4+ T-lymphocyte count. Treatment of HIV-positive TB usually results in microbiologic response but is associated with increased side effects and high mortality. Multi-drug-resistant TB (MDRTB), affecting mostly HIV-positive persons, has emerged in the United States as a major public health problem. Implications of HIV/TB for programmes, policy and research are reviewed. CONCLUSIONS: TB has been long neglected, and is now complicated by HIV/TB and MDRTB. Increased resources for programmes and research, and better coordination between HIV/AIDS and TB programmes are needed. International surveillance for MDRTB should be established.

Keywords: *AIDS-Related Opportunistic Infections/THERAPY *HIV
931130
M93B5828

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