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Multidrug-resistant and extensively drug-resistant tuberculosis: implications for the HIV epidemic and antiretroviral therapy rollout in South Africa.
J Infect Dis. 2007 Dec 01; 196 Suppl 3:S482-90.JI

Abstract

Drug-resistant tuberculosis (TB) is emerging as a major clinical and public health challenge in areas of sub-Saharan Africa where there is a high prevalence of human immunodeficiency virus (HIV) infection. TB drug-resistance surveillance in this region has been limited by laboratory capacity and the public health infrastructure; however, with the maturation of the HIV epidemic, the burden of drug-resistant TB is increasing rapidly. The recent discovery of large numbers of cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB in South Africa likely represents an unrecognized and evolving epidemic rather than sporadic, localized outbreaks. The combination of a large population of HIV-infected susceptible hosts with poor TB treatment success rates, a lack of airborne infection control, limited drug-resistance testing, and an overburdened MDR-TB treatment program provides ideal conditions for an MDR-TB and XDR-TB epidemic of unparalleled magnitude. In the present article, we review the history of drug-resistant TB in South Africa, describe its interaction with the HIV epidemic and the resultant consequences, and suggest measures necessary for controlling MDR-TB and XDR-TB in this context. A successful response to the emergence of MDR-TB and XDR-TB will necessitate increased resources for and collaboration between TB and HIV programs.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Andrews JR
Yale University School of Medicine, New Haven, Connecticut 06510-2483, USA. Jasonandr@gmail.com
Shah NS
No affiliation info available
Gandhi N
No affiliation info available
Moll T
No affiliation info available
Friedland G
No affiliation info available
Tugela Ferry Care and Research (TF CARES) Collaboration
No affiliation info available

MeSH

AIDS-Related Opportunistic InfectionsAntiretroviral Therapy, Highly ActiveExtensively Drug-Resistant TuberculosisHIV InfectionsHumansSouth AfricaTuberculosis, Multidrug-Resistant

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18181698

Citation

Andrews, Jason R., et al. "Multidrug-resistant and Extensively Drug-resistant Tuberculosis: Implications for the HIV Epidemic and Antiretroviral Therapy Rollout in South Africa." The Journal of Infectious Diseases, vol. 196 Suppl 3, 2007, pp. S482-90.
Andrews JR, Shah NS, Gandhi N, et al. Multidrug-resistant and extensively drug-resistant tuberculosis: implications for the HIV epidemic and antiretroviral therapy rollout in South Africa. J Infect Dis. 2007;196 Suppl 3:S482-90.
Andrews, J. R., Shah, N. S., Gandhi, N., Moll, T., & Friedland, G. (2007). Multidrug-resistant and extensively drug-resistant tuberculosis: implications for the HIV epidemic and antiretroviral therapy rollout in South Africa. The Journal of Infectious Diseases, 196 Suppl 3, S482-90. https://doi.org/10.1086/521121
Andrews JR, et al. Multidrug-resistant and Extensively Drug-resistant Tuberculosis: Implications for the HIV Epidemic and Antiretroviral Therapy Rollout in South Africa. J Infect Dis. 2007 Dec 1;196 Suppl 3:S482-90. PubMed PMID: 18181698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multidrug-resistant and extensively drug-resistant tuberculosis: implications for the HIV epidemic and antiretroviral therapy rollout in South Africa. AU - Andrews,Jason R, AU - Shah,N Sarita, AU - Gandhi,Neel, AU - Moll,Tony, AU - Friedland,Gerald, AU - ,, PY - 2008/1/10/pubmed PY - 2008/2/26/medline PY - 2008/1/10/entrez SP - S482 EP - 90 JF - The Journal of infectious diseases JO - J Infect Dis VL - 196 Suppl 3 N2 - Drug-resistant tuberculosis (TB) is emerging as a major clinical and public health challenge in areas of sub-Saharan Africa where there is a high prevalence of human immunodeficiency virus (HIV) infection. TB drug-resistance surveillance in this region has been limited by laboratory capacity and the public health infrastructure; however, with the maturation of the HIV epidemic, the burden of drug-resistant TB is increasing rapidly. The recent discovery of large numbers of cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB in South Africa likely represents an unrecognized and evolving epidemic rather than sporadic, localized outbreaks. The combination of a large population of HIV-infected susceptible hosts with poor TB treatment success rates, a lack of airborne infection control, limited drug-resistance testing, and an overburdened MDR-TB treatment program provides ideal conditions for an MDR-TB and XDR-TB epidemic of unparalleled magnitude. In the present article, we review the history of drug-resistant TB in South Africa, describe its interaction with the HIV epidemic and the resultant consequences, and suggest measures necessary for controlling MDR-TB and XDR-TB in this context. A successful response to the emergence of MDR-TB and XDR-TB will necessitate increased resources for and collaboration between TB and HIV programs. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/18181698/Multidrug_resistant_and_extensively_drug_resistant_tuberculosis:_implications_for_the_HIV_epidemic_and_antiretroviral_therapy_rollout_in_South_Africa_ DB - PRIME DP - Unbound Medicine ER -