Drug-Resistant Tuberculosis and HIV Infection: Current Perspectives

Abhijeet Singh, Rajendra Prasad, Viswesvaran Balasubramanian, Nikhil Gupta, Abhijeet Singh, Rajendra Prasad, Viswesvaran Balasubramanian, Nikhil Gupta

Abstract

Drug-resistant tuberculosis (DR-TB), including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), is considered a potential obstacle for elimination of TB globally. HIV coinfection with M/XDR-TB further complicates the scenario, and is a potential threat with challenging management. Reports have shown poor outcomes and alarmingly high mortality rates among people living with HIV (PLHIV) coinfected with M/XDR-TB. This coinfection is also responsible for all forms of M/XDR-TB epidemics or outbreaks. Better outcomes with reductions in mortality have been reported with concomitant treatment containing antiretroviral drugs for the HIV component and antitubercular drugs for the DR-TB component. Early and rapid diagnosis with genotypic tests, prompt treatment with appropriate regimens based on drug-susceptibility testing, preference for shorter regimens fortified with newer drugs, a patient-centric approach, and strong infection-control measures are all essential components in the management of M/XDR-TB in people living with HIV.

Keywords: HIV; drug-resistant; extensively drug-resistant; multidrug-resistant; tuberculosis.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2020 Singh et al.

Figures

Figure 1
Figure 1
Algorithm for diagnosis of drug-resistant tuberculosis in people living with HIV.

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