RT Journal Article
SR Electronic
T1 Understanding and intervening in HIV-associated tuberculosis
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP s43
OP s49
DO 10.7861/clinmedicine.15-6-s43
VO 15
IS Suppl 6
A1 Neesha Rockwood
A1 Robert John Wilkinson
YR 2015
UL http://www.rcpjournals.org/content/15/Suppl_6/s43.abstract
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.