PMID- 24295487
OWN - NLM
STAT- MEDLINE
DCOM- 20140326
LR  - 20231110
IS  - 1741-7015 (Electronic)
IS  - 1741-7015 (Linking)
VI  - 11
DP  - 2013 Dec 2
TI  - Management of HIV-associated tuberculosis in resource-limited settings: a 
      state-of-the-art review.
PG  - 253
LID - 10.1186/1741-7015-11-253 [doi]
AB  - The HIV-associated tuberculosis (TB) epidemic remains a huge challenge to public 
      health in resource-limited settings. Reducing the nearly 0.5 million deaths that 
      result each year has been identified as a key priority. Major progress has been 
      made over the past 10 years in defining appropriate strategies and policy 
      guidelines for early diagnosis and effective case management. Ascertainment of 
      cases has been improved through a twofold strategy of provider-initiated HIV 
      testing and counseling in TB patients and intensified TB case finding among those 
      living with HIV. Outcomes of rifampicin-based TB treatment are greatly enhanced 
      by concurrent co-trimoxazole prophylaxis and antiretroviral therapy (ART). ART 
      reduces mortality across a spectrum of CD4 counts and randomized controlled 
      trials have defined the optimum time to start ART. Good outcomes can be achieved 
      when combining TB treatment with first-line ART, but use with second-line ART 
      remains challenging due to pharmacokinetic drug interactions and cotoxicity. We 
      review the frequency and spectrum of adverse drug reactions and immune 
      reconstitution inflammatory syndrome (IRIS) resulting from combined treatment, 
      and highlight the challenges of managing HIV-associated drug-resistant TB.
FAU - Lawn, Stephen D
AU  - Lawn SD
AD  - Department of Clinical Research, Faculty of Infectious and Tropical Diseases, 
      London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, 
      UK. stephen.lawn@lshtm.ac.uk.
FAU - Meintjes, Graeme
AU  - Meintjes G
FAU - McIlleron, Helen
AU  - McIlleron H
FAU - Harries, Anthony D
AU  - Harries AD
FAU - Wood, Robin
AU  - Wood R
LA  - eng
GR  - 100714/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20131202
PL  - England
TA  - BMC Med
JT  - BMC medicine
JID - 101190723
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Anti-Retroviral Agents/therapeutic use
MH  - Antitubercular Agents/*therapeutic use
MH  - Chemoprevention/methods
MH  - Developing Countries
MH  - Early Diagnosis
MH  - HIV Infections/*complications
MH  - Humans
MH  - Time Factors
MH  - Tuberculosis/*diagnosis/*drug therapy
PMC - PMC4220801
EDAT- 2013/12/04 06:00
MHDA- 2014/03/29 06:00
PMCR- 2013/12/02
CRDT- 2013/12/04 06:00
PHST- 2013/09/03 00:00 [received]
PHST- 2013/11/07 00:00 [accepted]
PHST- 2013/12/04 06:00 [entrez]
PHST- 2013/12/04 06:00 [pubmed]
PHST- 2014/03/29 06:00 [medline]
PHST- 2013/12/02 00:00 [pmc-release]
AID - 1741-7015-11-253 [pii]
AID - 10.1186/1741-7015-11-253 [doi]
PST - epublish
SO  - BMC Med. 2013 Dec 2;11:253. doi: 10.1186/1741-7015-11-253.