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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...

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Autores principales: van Griensven, Johan, Mohammed, Rezika, Ritmeijer, Koert, Burza, Sakib, Diro, Ermias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
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.
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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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