PT  - JOURNAL ARTICLE
AU  - Neesha Rockwood
AU  - Robert John Wilkinson
TI  - Understanding and intervening in HIV-associated tuberculosis
AID  - 10.7861/clinmedicine.15-6-s43
DP  - 2015 Dec 01
TA  - Clinical Medicine
PG  - s43--s49
VI  - 15
IP  - Suppl 6
4099  - http://www.rcpjournals.org/content/15/Suppl_6/s43.short
4100  - http://www.rcpjournals.org/content/15/Suppl_6/s43.full
SO  - Clin Med2015 Dec 01; 15
AB  - HIV-associated tuberculosis can present as extremes, ranging from acute life-threatening disseminated disease to occult asymptomatic infection. Both ends of this spectrum have distinct pathological correlates and require specific diagnostic and treatment approaches. Novel therapeutics, targeting both pathogen and host, are needed to augment pathogen clearance. In latent tuberculosis infection, enhancement of immune activation could be desirable. Antiretroviral therapy augments the beneficial effects of antitubercular therapy. However, in the context of high bacillary burden, antiretroviral therapy can also result in pathology (tuberculosis immune reconstitution inflammatory syndrome). In the immune reconstituting patient, modulation of immune activation controls tissue destruction. Interventions should also be appropriate and sustainable within the programmatic setting.