Active tuberculosis The optimal diagnosis of active TB involves early and accurate bacteriological confirmation in order to confirm M. tuberculosis infection and to detect potential anti-mycobacterial drug-resistance at baseline. Early diagnosis of HIV-associated TB can be difficult due to the non-specific clinical symptoms, inadequate diagnostic tools available and failure to consider it in the differential …
The management of active TB-HIV co-infection involves prompt initiation of an appropriate multidrug TB regimen that is guided by DST, commencing cART and treatment monitoring. The ASHM Antiretroviral Guidelines, an Australian handbook and several international guidelines include a more complete discussion of the diagnosis and treatment of TB in patients with HIV infection. TB can be a …
TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) occurs in two forms, unmasking and paradoxical. Case definitions have been published for resource-limited settings. Disease pathogenesis mechanisms are similar for both forms of TB-IRIS and reflect restoration of an immune response against M. tuberculosis after administration of cART that results in an exaggerated inflammatory response to live or …
TB-associated immune reconstitution inflammatory syndrome Read More »
Close collaboration among clinicians, health-care institutions and public health programs involved in the diagnosis and treatment of patients with HIV infection and TB is necessary in order to integrate care and improve patient outcomes. A specialist or specialists with appropriate expertise should supervise the management of all patients with HIV-TB co-infection in Australia. Hospital admission …
Treatment of LTBI to prevent the development of active TB is called preventive treatment (PT; previously prophylaxis) and is often commenced irrespective of confirmed LTBI diagnosis and based on risk of LTBI. Preventive treatment can reduce the progression of LTBI to active TB in people with HIV infection by 32-62% and reduces the risk of …
Treatment of latent tuberculosis infection (preventive treatment) Read More »
World Health Organization. Global tuberculosis report 2018. Geneva: WHO; 2018. Available at: https://www.who.int/tb/publications/global_report/en/ Majumdar SS, Marais BJ, Denholm JT, Britton WJ. Drug-resistant tuberculosis: collaborative regional leadership required. Med J Aust 2014;200:241–2. Toms C, Stapledon R, Douglas P, National Tuberculosis Advisory Committee, for the Communicable Diseases Network Australia, Australian Mycobacterium Reference Laboratory Network, (null), et al. …
Dani Lin1, Ian Woolley1,2, Jeffrey Post3 Monash Infectious Diseases Department of Medicine, Monash University, Melbourne VIC Prince of Wales Hospital and Prince of Wales Clinical School, UNSW Last reviewed: October 2019 Introduction Respiratory complaints amongst people with HIV infection are common with a wide range of aetiologies, although the majority will be caused by common …
Respiratory tract infections in patients with HIV infection Read More »
The degree of immunodeficiency, as indicated by the blood CD4+ T cell count, provides a guide to the differential diagnosis of respiratory tract disease in HIV patients (Table 1). Table 1. Pathogens causing respiratory tract disease in patients with HIV infection at different CD4+ T cell counts CD4+ T cell count (cells/mL) Bacterial Fungal Viral …
General approach to the assessment of respiratory tract infections Read More »
Sinusitis is a common problem in people with HIV infection. In one retrospective review, 11% of hospitalised patients were affected by this disorder.18 Sinusitis is more common with immunodeficiency (CD4+ T cell count < 200/μL), and it is more likely to be extensive and chronic in very immunodeficient patients. Up to one-third of cases may be …
Bacterial pneumonia is a significant cause of morbidity and mortality in people with HIV infection. It is predominantly caused by S. pneumoniae. People with HIV are at much higher risk of invasive pneumococcal infection than the general population, with the incidence of pneumococcal bacteraemia 100 times that of age-matched populations, and pneumococcal pneumonia rates five …
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
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