Skip to main content
PMC home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
editorial
. 2007 Dec;99(12):1414–1419.

HIV and tuberculosis coinfection: inextricably linked liaison.

Vincent Idemyor
PMCID: PMC2575925  PMID: 18229780

Abstract

In sub-Saharan Africa, human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (TB) are among the leading causes of morbidity and mortality. Sub-Saharan Africa has seen the woeful failure of World Health Organization (WHO) targets of detecting 70% of the infectious cases of tuberculosis and curing > or =85%. Current treatment of Mycobacterium tuberculosis in most resource limited settings is comprised of a four-drug initial antituberculosis regimen for two months, followed by either a two-drug continuation phase of antituberculosis regimen for four months or six months depending on the medications. Many countries in sub-Saharan Africa are scaling up with highly active antiretroviral therapy (HAART), using one of the first-line regimens that consist of two nucleoside reverse transcriptase inhibitors (NRTI) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Our current HAART regimen and antituberculosis drugs continue to give us a therapeutic challenge in terms of adverse effects, drug-drug interactions and immune reconstitution inflammatory syndromes. Scientific research is needed in the areas of diagnosis, treatment and prevention of tuberculosis in sub-Saharan Africa. Such research could be facilitated due to greater availability of funding than a decade ago.

Full text

PDF
1417

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ansari N. A., Kombe A. H., Kenyon T. A., Hone N. M., Tappero J. W., Nyirenda S. T., Binkin N. J., Lucas S. B. Pathology and causes of death in a group of 128 predominantly HIV-positive patients in Botswana, 1997-1998. Int J Tuberc Lung Dis. 2002 Jan;6(1):55–63. [PubMed] [Google Scholar]
  2. Badri Motasim, Wilson Douglas, Wood Robin. Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: a cohort study. Lancet. 2002 Jun 15;359(9323):2059–2064. doi: 10.1016/S0140-6736(02)08904-3. [DOI] [PubMed] [Google Scholar]
  3. Burman W. J., Gallicano K., Peloquin C. Therapeutic implications of drug interactions in the treatment of human immunodeficiency virus-related tuberculosis. Clin Infect Dis. 1999 Mar;28(3):419–430. doi: 10.1086/515174. [DOI] [PubMed] [Google Scholar]
  4. Chintu C., Bhat G. J., Walker A. S., Mulenga V., Sinyinza F., Lishimpi K., Farrelly L., Kaganson N., Zumla A., Gillespie S. H. Co-trimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind randomised placebo-controlled trial. Lancet. 2004 Nov 20;364(9448):1865–1871. doi: 10.1016/S0140-6736(04)17442-4. [DOI] [PubMed] [Google Scholar]
  5. Churchyard G. J., Kleinschmidt I., Corbett E. L., Mulder D., De Cock K. M. Mycobacterial disease in South African gold miners in the era of HIV infection. Int J Tuberc Lung Dis. 1999 Sep;3(9):791–798. [PubMed] [Google Scholar]
  6. Churchyard Gavin J., Fielding Katherine, Charalambous Salome, Day John H., Corbett Elizabeth L., Hayes Richard J., Chaisson Richard E., De Cock Kevin M., Samb Badara, Grant Alison D. Efficacy of secondary isoniazid preventive therapy among HIV-infected Southern Africans: time to change policy? AIDS. 2003 Sep 26;17(14):2063–2070. doi: 10.1097/00002030-200309260-00007. [DOI] [PubMed] [Google Scholar]
  7. Cohen Ted, Lipsitch Marc, Walensky Rochelle P., Murray Megan. Beneficial and perverse effects of isoniazid preventive therapy for latent tuberculosis infection in HIV-tuberculosis coinfected populations. Proc Natl Acad Sci U S A. 2006 Apr 21;103(18):7042–7047. doi: 10.1073/pnas.0600349103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Corbett Elizabeth L., Watt Catherine J., Walker Neff, Maher Dermot, Williams Brian G., Raviglione Mario C., Dye Christopher. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med. 2003 May 12;163(9):1009–1021. doi: 10.1001/archinte.163.9.1009. [DOI] [PubMed] [Google Scholar]
  9. De Cock K. M., Soro B., Coulibaly I. M., Lucas S. B. Tuberculosis and HIV infection in sub-Saharan Africa. JAMA. 1992 Sep 23;268(12):1581–1587. doi: 10.1001/jama.268.12.1581. [DOI] [PubMed] [Google Scholar]
  10. Dean Gillian L., Edwards Simon G., Ives Natalie J., Matthews Gail, Fox Emma F., Navaratne Lesley, Fisher Martin, Taylor Graham P., Miller Rob, Taylor Chris B. Treatment of tuberculosis in HIV-infected persons in the era of highly active antiretroviral therapy. AIDS. 2002 Jan 4;16(1):75–83. doi: 10.1097/00002030-200201040-00010. [DOI] [PubMed] [Google Scholar]
  11. Dorman Susan E., Chaisson Richard E. From magic bullets back to the magic mountain: the rise of extensively drug-resistant tuberculosis. Nat Med. 2007 Mar;13(3):295–298. doi: 10.1038/nm0307-295. [DOI] [PubMed] [Google Scholar]
  12. Dye Christopher, Watt Catherine J., Bleed Daniel. Low access to a highly effective therapy: a challenge for international tuberculosis control. Bull World Health Organ. 2002;80(6):437–444. [PMC free article] [PubMed] [Google Scholar]
  13. Elliott A. M., Halwiindi B., Hayes R. J., Luo N., Mwinga A. G., Tembo G., Machiels L., Steenbergen G., Pobee J. O., Nunn P. P. The impact of human immunodeficiency virus on response to treatment and recurrence rate in patients treated for tuberculosis: two-year follow-up of a cohort in Lusaka, Zambia. J Trop Med Hyg. 1995 Feb;98(1):9–21. [PubMed] [Google Scholar]
  14. Elliott A. M., Halwiindi B., Hayes R. J., Luo N., Tembo G., Machiels L., Bem C., Steenbergen G., Pobee J. O., Nunn P. P. The impact of human immunodeficiency virus on presentation and diagnosis of tuberculosis in a cohort study in Zambia. J Trop Med Hyg. 1993 Feb;96(1):1–11. [PubMed] [Google Scholar]
  15. Fitzgerald D. W., Desvarieux M., Severe P., Joseph P., Johnson W. D., Jr, Pape J. W. Effect of post-treatment isoniazid on prevention of recurrent tuberculosis in HIV-1-infected individuals: a randomised trial. Lancet. 2000 Oct 28;356(9240):1470–1474. doi: 10.1016/S0140-6736(00)02870-1. [DOI] [PubMed] [Google Scholar]
  16. Githui W., Nunn P., Juma E., Karimi F., Brindle R., Kamunyi R., Gathua S., Gicheha C., Morris J., Omwega M. Cohort study of HIV-positive and HIV-negative tuberculosis, Nairobi, Kenya: comparison of bacteriological results. Tuber Lung Dis. 1992 Aug;73(4):203–209. doi: 10.1016/0962-8479(92)90087-Z. [DOI] [PubMed] [Google Scholar]
  17. Grant A. D., Djomand G., De Cock K. M. Natural history and spectrum of disease in adults with HIV/AIDS in Africa. AIDS. 1997;11 (Suppl B):S43–S54. [PubMed] [Google Scholar]
  18. Harries Anthony D., Chimzizi Rhehab, Zachariah Rony. Safety, effectiveness, and outcomes of concomitant use of highly active antiretroviral therapy with drugs for tuberculosis in resource-poor settings. Lancet. 2006 Mar 18;367(9514):944–945. doi: 10.1016/S0140-6736(06)68387-6. [DOI] [PubMed] [Google Scholar]
  19. Johnson J. L., Vjecha M. J., Okwera A., Hatanga E., Byekwaso F., Wolski K., Aisu T., Whalen C. C., Huebner R., Mugerwa R. D. Impact of human immunodeficiency virus type-1 infection on the initial bacteriologic and radiographic manifestations of pulmonary tuberculosis in Uganda. Makerere University-Case Western Reserve University Research Collaboration. Int J Tuberc Lung Dis. 1998 May;2(5):397–404. [PubMed] [Google Scholar]
  20. Kwara A., Flanigan T. P., Carter E. J. Highly active antiretroviral therapy (HAART) in adults with tuberculosis: current status. Int J Tuberc Lung Dis. 2005 Mar;9(3):248–257. [PubMed] [Google Scholar]
  21. Lawn Stephen D., Bekker Linda-Gail, Miller Robert F. Immune reconstitution disease associated with mycobacterial infections in HIV-infected individuals receiving antiretrovirals. Lancet Infect Dis. 2005 Jun;5(6):361–373. doi: 10.1016/S1473-3099(05)70140-7. [DOI] [PubMed] [Google Scholar]
  22. Lucas S. B., Hounnou A., Peacock C., Beaumel A., Djomand G., N'Gbichi J. M., Yeboue K., Hondé M., Diomande M., Giordano C. The mortality and pathology of HIV infection in a west African city. AIDS. 1993 Dec;7(12):1569–1579. doi: 10.1097/00002030-199312000-00005. [DOI] [PubMed] [Google Scholar]
  23. Maher D., Borgdorff M., Boerma T. HIV-related tuberculosis: how well are we doing with current control efforts? Int J Tuberc Lung Dis. 2005 Jan;9(1):17–24. [PubMed] [Google Scholar]
  24. Manosuthi Weerawat, Ruxrungtham Kiat, Likanonsakul Sirirat, Prasithsirikul Wisit, Inthong Yaowarat, Phoorisri Thanongsri, Sungkanuparph Somnuek. Nevirapine levels after discontinuation of rifampicin therapy and 60-week efficacy of nevirapine-based antiretroviral therapy in HIV-infected patients with tuberculosis. Clin Infect Dis. 2006 Nov 21;44(1):141–144. doi: 10.1086/510078. [DOI] [PubMed] [Google Scholar]
  25. Mermin Jonathan, Lule John, Ekwaru John Paul, Malamba Samuel, Downing Robert, Ransom Ray, Kaharuza Frank, Culver David, Kizito Francis, Bunnell Rebecca. Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda. Lancet. 2004 Oct 16;364(9443):1428–1434. doi: 10.1016/S0140-6736(04)17225-5. [DOI] [PubMed] [Google Scholar]
  26. Mukadi Y. D., Maher D., Harries A. Tuberculosis case fatality rates in high HIV prevalence populations in sub-Saharan Africa. AIDS. 2001 Jan 26;15(2):143–152. doi: 10.1097/00002030-200101260-00002. [DOI] [PubMed] [Google Scholar]
  27. Munyati Shungu S., Dhoba Temba, Makanza Evelyn D., Mungofa Stanley, Wellington Maureen, Mutsvangwa Junior, Gwanzura Lovemore, Hakim James, Nyakabau Morgan, Mason Peter R. Chronic cough in primary health care attendees, Harare, Zimbabwe: diagnosis and impact of HIV infection. Clin Infect Dis. 2005 May 12;40(12):1818–1827. doi: 10.1086/429912. [DOI] [PubMed] [Google Scholar]
  28. Rana F. S., Hawken M. P., Mwachari C., Bhatt S. M., Abdullah F., Ng'ang'a L. W., Power C., Githui W. A., Porter J. D., Lucas S. B. Autopsy study of HIV-1-positive and HIV-1-negative adult medical patients in Nairobi, Kenya. J Acquir Immune Defic Syndr. 2000 May 1;24(1):23–29. doi: 10.1097/00126334-200005010-00004. [DOI] [PubMed] [Google Scholar]
  29. Ribera E., Pou L., Lopez R. M., Crespo M., Falco V., Ocaña I., Ruiz I., Pahissa A. Pharmacokinetic interaction between nevirapine and rifampicin in HIV-infected patients with tuberculosis. J Acquir Immune Defic Syndr. 2001 Dec 15;28(5):450–453. doi: 10.1097/00042560-200112150-00007. [DOI] [PubMed] [Google Scholar]
  30. Sonnenberg P., Murray J., Glynn J. R., Shearer S., Kambashi B., Godfrey-Faussett P. HIV-1 and recurrence, relapse, and reinfection of tuberculosis after cure: a cohort study in South African mineworkers. Lancet. 2001 Nov 17;358(9294):1687–1693. doi: 10.1016/S0140-6736(01)06712-5. [DOI] [PubMed] [Google Scholar]
  31. Wiktor S. Z., Sassan-Morokro M., Grant A. D., Abouya L., Karon J. M., Maurice C., Djomand G., Ackah A., Domoua K., Kadio A. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Côte d'Ivoire: a randomised controlled trial. Lancet. 1999 May 1;353(9163):1469–1475. doi: 10.1016/s0140-6736(99)03465-0. [DOI] [PubMed] [Google Scholar]
  32. Zachariah R., Massaquoi M. Cotrimoxazole prophylaxis for HIV-positive TB patients in developing countries. Trop Doct. 2006 Apr;36(2):79–82. doi: 10.1258/004947506776593314. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES