Optimal Management of Drug-Resistant Tuberculosis and Human Immunodeficiency Virus: an Update

Purpose of Review Rifampicin-resistant tuberculosis (RR-TB) in a growing global health crisis. RR-TB and HIV co-infection is common, and this dual infection brings with it unique diagnostic and treatment challenges. Here, we review the most recent developments in the epidemiology, prevention, diagno...

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Bibliographic Details
Published in:Current treatment options in infectious disease 2018-03, Vol.10 (1), p.90-106
Main Authors: Reuter, Anja, Furin, Jennifer
Format: Article
Language:English
Subjects:
Antiretroviral drugs
Clinical outcomes
Clofazimine
Diagnosis
Drug resistance
Epidemiology
HIV
HIV Medicine (CJ Yoon
Human immunodeficiency virus
Infectious Diseases
Linezolid
Medicine
Medicine & Public Health
Reviews
Rifampin
Section Editor
Topical Collection on HIV Medicine
Tuberculosis
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Summary:Purpose of Review Rifampicin-resistant tuberculosis (RR-TB) in a growing global health crisis. RR-TB and HIV co-infection is common, and this dual infection brings with it unique diagnostic and treatment challenges. Here, we review the most recent developments in the epidemiology, prevention, diagnoses, and treatment—including the use of novel antituberculosis drugs—for these diseases. We also review strategies to combat stigma and support adherence for people living with HIV and RR-TB. Recent Findings Advances in RR-TB diagnosis include genotypic tests, most notably Xpert MTB/RIF. Novel therapeutic advances in the treatment of RR-TB among people living with HIV include the use of new drugs (bedaquiline and delamanid), repurposed drugs (linezolid and clofazimine), and novel regimens (a shortened 9–12-month treatment). However, access to advances in diagnosis and treatment of RR-TB in people living with HIV is limited. Furthermore, there is a significant amount of stigma and discrimination against people with both HIV and RR-TB, and this could affect treatment outcomes via challenges with adherence. Summary We conclude that with high-quality diagnostics, treatment, and support, people living with HIV and RR-TB have good treatment outcomes; thus, access to all of these interventions is an urgent global priority.
ISSN:1534-6250
1523-3820
1534-6250
DOI:10.1007/s40506-018-0145-0