TY - JOUR T1 - Understanding and intervening in HIV-associated tuberculosis JF - Clinical Medicine JO - Clin Med SP - s43 LP - s49 DO - 10.7861/clinmedicine.15-6-s43 VL - 15 IS - Suppl 6 AU - Neesha Rockwood AU - Robert John Wilkinson Y1 - 2015/12/01 UR - http://www.rcpjournals.org/content/15/Suppl_6/s43.abstract N2 - 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. ER -