Table of Contents
Introduction. 3
Part 1. HIV-Associated Tuberculosis. 5
Part 2. Treatment Options for HIV-Associated Tuberculosis. 7
Results. 10
References. 11
Glossary. 12
Appendix. 17
The aim of the paper was to consider the essence of HIV-associated TB and outline the existing treatment options for HIV-Associated Tuberculosis. Having analyzed the publications on the topic, we came to the following conclusions.
The HIV-associated TB epidemic is a major challenge to international public health, remaining the most important opportunistic infection in people living with HIV globally and accounting for nearly 0.5 million deaths each year. However, over the past 10 years, major progress has been achieved in defining guidelines for the optimum case management with a combination of co-trimoxazole prophylaxis, optimally timed ART, and diagnosis and appropriate supportive care for treatment complications including drug toxicity and IRIS. The major remaining challenges are the management of TB in the increasing proportion of patients receiving PI-containing ART and the management of drug resistant TB. Having defined case management strategies, the ongoing challenge is to further develop effective, comprehensive and sustainable means of delivery through health systems.
HIV-associated pulmonary TB mandates a committed approach that encompasses both effective as well as enduring therapy originating from newer drug combinations, evolving ideas and emerging concepts from clinical trials globally, which if implemented in a proper and coordinated manner could not only save millions of lives but also offer a better quality of life to patients suffering from this coinfection.
The aim of TB treatment is to achieve cure, to prevent death and relapse, and to render patients noninfectious as rapidly as possible, as well as to prevent the emergence of drug resistance. Anti-TB agents are, therefore, selected (1) to kill the actively metabolizing bacilli in the cavities, (2) to destroy less actively replicating bacilli in the acidic and anoxic closed lesions, and (3) to kill near-dormant bacilli that might otherwise cause a relapse of the disease. The most effective agents for the destruction of tubercle bacilli in the 3 categories described above are, respectively, isoniazid, pyrazinamide, and rifampin.
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