|
Tuberculosis Still a Risk for Patients Receiving HIV Drugs
November 14, 2005People taking highly active antiretroviral therapy (HAART) for HIV infection remain susceptible to tuberculosis, though the risk is lower than for HIV-infected patients not on HAART, according to an article in the Dec. 15 issue of Clinical Infectious Diseases, now available online.
Opportunistic infections such as tuberculosis (TB) can be fatal for immunocompromised patients. HAART not only reduces the viral load of HIV, but it also often helps to keep other infections such as TB under control. In fact, previous studies indicate that HAART can reduce the risk of TB in HIV patients by 70 to 90 percent. Although HIV-infected people living in industrialized nations are at lower risk of TB than those living in resource-poor countries, it continues to be a significant problem for HIV-infected people everywhere.
A group of European and American researchers followed patients with HIV for three years after they began HAART. The rate of tuberculosis was highest within the first three months of therapy, but declined after longer HAART exposure. Patients' risk of developing tuberculosis more than doubled if HAART did not successfully control their HIV. Patients were also more likely to develop TB if they were more immunodeficient when they started taking HAART.
HIV-infected patients from industrialized nations might develop TB if they were exposed to the tuberculosis organism in the past, especially for those emigrating from resource-poor countries. Their weakened immune status can allow reactivation of latent TB infection, according to lead author Enrico Girardi, MD, of the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani in Rome.
But they don't necessarily have to leave the country to contract TB. HIV-infected American and European patients who are "exposed to someone with tuberculosis, for example in a hospital setting, are at increased risk of acquiring tuberculosis infection and of developing active tuberculosis within a short time, usually six months to one year," Dr. Girardi said.
Since TB is a potentially deadly opportunistic infection for patients with HIV, doctors need to be aware of the risk and take certain precautionary measures. "HIV-infected patients, even when treated with HAART, remain at increased risk of developing tuberculosis," Dr. Girardi said. "Thus, physicians caring for patients with HIV should continue to screen for and to treat latent tuberculosis infection in their patients, even if they have minor levels of immune suppression or are successfully treated with HAART." Health care settings should also maintain strict control measures to prevent the spread of tuberculosis to patients being treated for HIV, Dr. Girardi added.
In an accompanying editorial commentary, Stephen D. Lawn, MRCP, MD, and Robin Wood, MBChB, of the Desmond Tutu HIV Centre in South Africa indicated similar findings (unpublished) related to patients' immunological response to HAART and subsequent development of TB. The commentary concludes that HIV-infected patients' risk for infection with TB "remains elevated among those receiving treatment in both high- and low-income countries."
Infectious Diseases Society of America
HIV-infected patients from industrialized nations might develop TB if they were exposed to the tuberculosis organism in the past, especially for those emigrating from resource-poor countries. Their weakened immune status can allow reactivation of latent TB infection, according to lead author Enrico Girardi, MD, of the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani in Rome.
But they don't necessarily have to leave the country to contract TB. HIV-infected American and European patients who are "exposed to someone with tuberculosis, for example in a hospital setting, are at increased risk of acquiring tuberculosis infection and of developing active tuberculosis within a short time, usually six months to one year," Dr. Girardi said.
Since TB is a potentially deadly opportunistic infection for patients with HIV, doctors need to be aware of the risk and take certain precautionary measures. "HIV-infected patients, even when treated with HAART, remain at increased risk of developing tuberculosis," Dr. Girardi said. "Thus, physicians caring for patients with HIV should continue to screen for and to treat latent tuberculosis infection in their patients, even if they have minor levels of immune suppression or are successfully treated with HAART." Health care settings should also maintain strict control measures to prevent the spread of tuberculosis to patients being treated for HIV, Dr. Girardi added.
In an accompanying editorial commentary, Stephen D. Lawn, MRCP, MD, and Robin Wood, MBChB, of the Desmond Tutu HIV Centre in South Africa indicated similar findings (unpublished) related to patients' immunological response to HAART and subsequent development of TB. The commentary concludes that HIV-infected patients' risk for infection with TB "remains elevated among those receiving treatment in both high- and low-income countries."
Infectious Diseases Society of America
Tuberculosis News and Current Tuberculosis Events RSSStudy helps identify which populations of foreign-born persons living in US at higher risk of TB
The relative yield of finding and treating latent tuberculosis is particularly high among higher-risk groups of foreign-born persons living in the U.S., such as individuals from most countries of sub-Saharan Africa and Southeast Asia.
Tuberculosis presents major challenges to HIV treatment in developing countries
Human immunodeficiency virus (HIV) care and treatment programs in resource-limited settings must aggressively address tuberculosis (TB) and the emerging multidrug-resistant TB epidemic to save patient lives and to curb the global TB burden, a major cause of death for persons with HIV.
Bovine tuberculosis in wildlife threatens endangered lynx and cattle health
In an epidemiological survey of Spain's Doņana National Park, the findings of which are published on July 23 in the journal PLoS ONE, Christian Gortázar and colleagues studied the prevalence of bovine tuberculosis (bovine TB) infection among populations of wild boar, red deer and fallow deer in the national park, which is located in southern Spain.
New Guidelines for Treating Rheumatoid Arthritis
Proven combinations of medicines and the introduction of new anti-arthritis drugs have significantly improved the treatment of rheumatoid arthritis (RA), according to guidelines issued by the American College of Rheumatology and co-authored by physicians at the University of Alabama at Birmingham (UAB).
Malaria Millennium Development Goal 'unlikely to be met'
The Millennium Development Goal (MDG) to halt and begin to reverse the incidence of malaria globally is unlikely to be met, according to Wellcome Trust Principal Research Fellow Professor Bob Snow.
New indicator uncovered that can predict coral health
A new indicator of coral health has been discovered in a community of microscopic single-celled algae called dinoflagellates.
D-cycloserine may improve behavioral therapy treatment for anxiety
Anxiety is a normal human response to stress, but in some, it can develop into a disabling disorder of excessive and irrational fears, such as obsessive-compulsive disorder, panic disorder, or posttraumatic stress disorder. Effective treatments are available and can involve either behavioral therapy or medications.
New Electrostatic-based DNA Microarray Technique Could Revolutionize Medical Diagnostics
The dream of personalized medicine - in which diagnostics, risk predictions and treatment decisions are based on a patient's genetic profile - may be on the verge of being expanded beyond the wealthiest of nations with state-of-the-art clinics.
Predicting TB outbreaks based on the first 2 cases
Outbreaks of tuberculosis (TB) may be able to be identified by looking at certain characteristics of the first two patients, according to new research.
Radical reform is needed to stop the 'inhumane' practice of transplant tourism
The UK government must bring in presumed consent to organ donation or allow a controlled donor compensation programme for unrelated live donors, in order to bring the "inhumane" practice of transplant tourism from the UK to an end, claims a doctor in this week's BMJ.
More Tuberculosis News Articles
 | The Air We Breathe: A Novel by Andrea Barrett |
 | Illness as Metaphor and AIDS and Its Metaphors by Susan Sontag |
 | Joe Gans: A Biography of the First African American World Boxing Champion by Colleen Aycock, Mark Scott |
 | Identification Problems in the Social Sciences by Charles F. Manski |
 | Basic Infection Control for Healthcare Providers by Michael Kennamer |
 | Towns of the Sandia Mountains (NM) (Images of America) by Mike Smith |
 | The White Plague: Tuberculosis, Man, and Society by Rene J. Dubos |
 | The White Death: A History of Tuberculosis by Thomas Dormandy |
| 13 is too young to die by Isaacsen-Bright | |
 | WINGS OF THE DOVE, THE - KINDLE EDITION [ENG] by Henry James |
| © 2008 BrightSurf.com |