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Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes?
BACKGROUND: Visceral leishmaniasis (VL)-human immunodeficiency virus (HIV) coinfection remains a major problem in Ethiopia, India, and Brazil. Tuberculosis (TB), a treatable factor, could contribute to high mortality (up to 25%) in VL-HIV coinfection. However, the current evidence on the prevalence...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925430/ https://www.ncbi.nlm.nih.gov/pubmed/29732379 http://dx.doi.org/10.1093/ofid/ofy059 |
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author | van Griensven, Johan Mohammed, Rezika Ritmeijer, Koert Burza, Sakib Diro, Ermias |
author_facet | van Griensven, Johan Mohammed, Rezika Ritmeijer, Koert Burza, Sakib Diro, Ermias |
author_sort | van Griensven, Johan |
collection | PubMed |
description | BACKGROUND: Visceral leishmaniasis (VL)-human immunodeficiency virus (HIV) coinfection remains a major problem in Ethiopia, India, and Brazil. Tuberculosis (TB), a treatable factor, could contribute to high mortality (up to 25%) in VL-HIV coinfection. However, the current evidence on the prevalence and clinical impact of TB in VL-HIV coinfection is very limited. In previous reports on routine care, TB prevalence ranged from 5.7% to 29.7%, but information on how and when TB was diagnosed was lacking. METHODS: Field observations suggest that TB work-up is often not done systematically, and it is only done in patients who do not respond well to VL treatment. Here, we advocate high-quality diagnostic studies in VL-HIV-coinfected patients, during which all patients are systematically screened for TB, including a comprehensive work-up, to obtain reliable estimates. RESULTS: Cost-effective and feasible diagnostic algorithms can be developed for field use, and this can be integrated in VL clinical guidelines. CONCLUSIONS: An accurate diagnosis of TB can allow clinicians to assess its clinical impact and evaluate the impact of early TB diagnosis. |
format | Online Article Text |
id | pubmed-5925430 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-59254302018-05-04 Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? van Griensven, Johan Mohammed, Rezika Ritmeijer, Koert Burza, Sakib Diro, Ermias Open Forum Infect Dis Major Article BACKGROUND: Visceral leishmaniasis (VL)-human immunodeficiency virus (HIV) coinfection remains a major problem in Ethiopia, India, and Brazil. Tuberculosis (TB), a treatable factor, could contribute to high mortality (up to 25%) in VL-HIV coinfection. However, the current evidence on the prevalence and clinical impact of TB in VL-HIV coinfection is very limited. In previous reports on routine care, TB prevalence ranged from 5.7% to 29.7%, but information on how and when TB was diagnosed was lacking. METHODS: Field observations suggest that TB work-up is often not done systematically, and it is only done in patients who do not respond well to VL treatment. Here, we advocate high-quality diagnostic studies in VL-HIV-coinfected patients, during which all patients are systematically screened for TB, including a comprehensive work-up, to obtain reliable estimates. RESULTS: Cost-effective and feasible diagnostic algorithms can be developed for field use, and this can be integrated in VL clinical guidelines. CONCLUSIONS: An accurate diagnosis of TB can allow clinicians to assess its clinical impact and evaluate the impact of early TB diagnosis. Oxford University Press 2018-03-16 /pmc/articles/PMC5925430/ /pubmed/29732379 http://dx.doi.org/10.1093/ofid/ofy059 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article van Griensven, Johan Mohammed, Rezika Ritmeijer, Koert Burza, Sakib Diro, Ermias Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title | Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title_full | Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title_fullStr | Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title_full_unstemmed | Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title_short | Tuberculosis in Visceral Leishmaniasis-Human Immunodeficiency Virus Coinfection: An Evidence Gap in Improving Patient Outcomes? |
title_sort | tuberculosis in visceral leishmaniasis-human immunodeficiency virus coinfection: an evidence gap in improving patient outcomes? |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925430/ https://www.ncbi.nlm.nih.gov/pubmed/29732379 http://dx.doi.org/10.1093/ofid/ofy059 |
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