Expertos Invitados





ASPECTOS CLINICOS DE LA TUBERCULOSIS EN PACIENTES INFECTADOS POR EL VIRUS DE LA INMUNODEFICIENCIA HUMANA

(especial para SIIC © Derechos reservados)
Fortalecer los programas de salud permitirá disminuir la transmisión y controlar la epidemia hasta que se puedan tener vacunas efectivas para cada una de las infecciones.
kato9.jpg Autor:
Midori Kato-maeda
Columnista Experto de SIIC

Institución:
Division of Pulmonary and Critical Care Medicine School of Medicine-San Francisco General Hospital University of California

Artículos publicados por Midori Kato-maeda
Recepción del artículo
29 de Marzo, 2005 		Aprobación
8 de Abril, 2005
Primera edición
28 de Noviembre, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

ASPECTOS CLINICOS DE LA TUBERCULOSIS EN PACIENTES INFECTADOS POR EL VIRUS DE LA INMUNODEFICIENCIA HUMANA

Resumen
La infección por el HIV es el factor de riesgo más importante para el desarrollo de la tuberculosis activa. Este artículo resume los aspectos epidemiológicos (con énfasis en América latina y el Caribe), clínicos, diagnósticos y del tratamiento de la tuberculosis en pacientes infectados por el HIV. En América latina y el Caribe, 5.1% de los casos nuevos de tuberculosis diagnosticados en el 2002 se asociaron con el HIV. La presentación clínica de la tuberculosis es similar a la de los pacientes sin la infección viral. Sin embargo, conforme avanza la inmunosupresión, el cuadro clínico se vuelve más atípico y es frecuente observar formas extrapulmonares. Asimismo, la sensibilidad y la especificidad de los métodos diagnósticos disminuyen a medida que se profundiza la inmunodeficiencia. El tratamiento es efectivo, aunque existe mayor mortalildad cuando la inmunosupresión es grave. Debido a que estas dos epidemias tienen aspectos en común, actualmente los programas de salud están coordinando esfuerzos para lograr controlar ambas epidemias.

Palabras clave
Tuberculosis, HIV, epidemiología en Latinoamérica, clínica


Artículo completo
(castellano)
Extensión:  +/-6.55 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

CLINICAL ASPECTS OF TUBERCULOSIS IN PATIENTS INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS

Abstract
HIV infection is the single most important risk factor for tuberculosis. This article summarizes the epidemiology (with emphasis in Latin America and the Caribbean), as well as the clinical presentation, diagnosis and treatment of tuberculosis in patients infected with HIV. In Latin America and the Caribbean, 5.1% of the new cases of tuberculosis diagnosed in 2002 were attributed to HIV. The clinical presentation is similar to patients without HIV. However, with severe immunosuppresion, the clinical presentation is atypical and is frequent to find extrapulmonary tuberculosis. Also, the sensitivity and specificity of the diagnostic methods decrease with the severity of the immunosuppresion. The treatment is similar and effective as in patients without HIV infection. However there is a higher mortality if the inmunosupression is severe. Because these two epidemics have several issues in common, currently, the health care programs are organizing strategies to coordinate efforts to control these two infections.

Key words
Tuberculosis, HIV, epidemiology in Latin America, clinical issues

Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Infectología
Relacionadas: Atención Primaria, Medicina Interna, Neumonología, Salud Pública



Comprar este artículo
Extensión: 6.55 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Bibliografía del artículo
  1. Selwyn PA, Hartel D, Lewis VA, et al: A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med 320:545-50, 1989.
  2. Vynnycky E, Fine PE: The natural history of tuberculosis: the implications of age-dependent risks of disease and the role of reinfection. Epidemiol Infect 119:183-201, 1997.
  3. Lawn SD, Butera ST, Folks TM: Contribution of immune activation to the pathogenesis and transmission of human immunodeficiency virus type 1 infection. Clin Microbiol Rev 14:753-77, table of contents, 2001.
  4. Alland D, Kalkut GE, Moss AR, et al: Transmission of tuberculosis in New York City. An analysis by DNA fingerprinting and conventional epidemiologic methods. N Engl J Med 330:1710-6, 1994.
  5. Daley CL, Small PM, Schecter GF, et al: An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction-fragment-length polymorphisms. N Engl J Med 326:231-5, 1992.
  6. Goletti D, Weissman D, Jackson RW, et al: Effect of Mycobacterium tuberculosis on HIV replication. Role of immune activation. J Immunol 157:1271-8, 1996.
  7. Toossi Z, Mayanja-Kizza H, Hirsch CS, et al: Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients. Clin Exp Immunol 123:233-8, 2001.
  8. Toossi Z: Virological and immunological impact of tuberculosis on human immunodeficiency virus type 1 disease. J Infect Dis 188:1146-55, 2003.
  9. Global Tuberculosis Control -Surveillance, Planning, Financing, WHO Report 2004. WHO/HTM/TB/2004.331, WHO, 2004.
  10. Corbett EL, Watt CJ, Walker N, et al: The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 163:1009-21, 2003.
  11. Situación epidemiológica de la TB (Región de las Américas, 2004), en Salud OPdl (ed): Programa Regional de Tuberculosis, Organización Panamericana de la Salud, 2004.
  12. Vigilancia del sida en las Américas. Informe Anual, UNAIDS, OPS, 2004, pp 1-21.
  13. García García ML, Valdespino Gómez JL, Palacios Martínez M et al. [Tuberculosis and AIDS in Mexico]. Salud Publica Mex 37:539-48, 1995.
  14. García I, Merchan A, Chaparro PE et al. [Overview of the HIV/tuberculosis coinfection in Bogota, Colombia, 2001]. Biomedica 24 Supp 1:132-7, 2004.
  15. Liberato IR, de Albuquerque MF, Campelo AR et al. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil. Rev Soc Bras Med Trop 37:46-50, 2004.
  16. Zavala Rosas D: Situación de la Asociación TB-HIV/SIDA. Región de las Américas, Organización Panamericana de la Salud.
  17. San Andrés FJ, Rubio R, Castilla J et al. Incidence of acquired immunodeficiency syndrome-associated opportunistic diseases and the effect of treatment on a cohort of 1115 patients infected with human immunodeficiency virus, 1989-1997. Clin Infect Dis 36:1177-85, 2003.
  18. Jones JL, Hanson DL, Dworkin MS et al. HIV-associated tuberculosis in the era of highly active antirretroviral therapy. The Adult/Adolescent Spectrum of HIV Disease Group. Int J Tuberc Lung Dis 4:1026-31, 2000.
  19. Santoro Lopes G, De Pinho AM, Harrison LH et al. Reduced risk of tuberculosis among Brazilian patients with advanced human immunodeficiency virus infection treated with highly active antirretroviral therapy. Clin Infect Dis 34:543-6, 2002.
  20. World Health Organization Europe: HIV/AIDS treatment: antirretroviral therapy, Fact Sheet EURO/06/03, WHO, 2003.
  21. Arbeláez MP, Nelson KE, Munoz A: BCG vaccine effectiveness in preventing tuberculosis and its interaction with human immunodeficiency virus infection. Int J Epidemiol 29:1085-91, 2000.
  22. Alpert PL, Munsiff SS, Gourevitch MN et al. A prospective study of tuberculosis and human immunodeficiency virus infection: clinical manifestations and factors associated with survival. Clin Infect Dis 24:661-8, 1997.
  23. Yang Z, Kong Y, Wilson F et al. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis 38:199-205, 2004.
  24. Barber TW, Craven DE, McCabe WR: Bacteremia due to Mycobacterium tuberculosis in patients with human immunodeficiency virus infection. A report of 9 cases and a review of the literature. Medicine (Baltimore) 69:375-83, 1990.
  25. Barnes PF, Lakey DL, Burman WJ: Tuberculosis in patients with HIV infection. Infect Dis Clin North Am 16:107-26, 2002.
  26. Centers for Disease Control and Prevention: Prevention and treatment of tuberculosis among patients infected with human immunodeficiency virus: principles of therapy and revised recommendations. Centers for Disease Control and Prevention. MMWR Recomm Rep 47:1-58, 1998.
  27. Blumberg HM, Burman WJ, Chaisson RE et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 167:603-62, 2003.
  28. Begg MD, Lamster IB, Panageas KS et al. A prospective study of oral lesions and their predictive value for progression of HIV disease. Oral Dis 3:176-83, 1997.
  29. Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement. Am J Respir Crit Care Med 161:S221-47, 2000.
  30. García García ML, Valdespino Gómez JL, García Sancho C et al. Underestimation of Mycobacterium tuberculosis infection in HIV-infected subjects using reactivity to tuberculin and anergy panel. Int J Epidemiol 29:369-75, 2000.
  31. Anergy skin testing and tuberculosis [corrected] preventive therapy for HIV-infected persons: revised recommendations. Centers for Disease Control and Prevention. MMWR Recomm Rep 46:1-10, 1997.
  32. Mazurek GH, Villarino ME. Guidelines for using the QuantiFERON-TB test for diagnosing latent Mycobacterium tuberculosis infection. Centers for Disease Control and Prevention. MMWR Recomm Rep 52:15-8, 2003.
  33. Hill PC, Brookes RH, Fox A et al. Large-scale evaluation of enzyme-linked immunospot assay and skin test for diagnosis of Mycobacterium tuberculosis infection against a gradient of exposure in The Gambia. Clin Infect Dis 38:966-73, 2004.
  34. Burman WJ, Jones BE: Clinical and radiographic features of HIV-related tuberculosis. Semin Respir Infect 18:263-71, 2003.
  35. Schluger NW: The diagnosis of tuberculosis: what’s old, what’s new. Semin Respir Infect 18:241-8, 2003.
  36. Update: Nucleic acid amplification tests for tuberculosis. MMWR Morb Mortal Wkly Rep 49:593-4, 2000.
  37. Kivhiya-Ndugga L, Van Cleeff M, Juma E et al. Comparison of PCR with the routine procedure for diagnosis of tuberculosis in a population with high prevalences of tuberculosis and human immunodeficiency virus. J Clin Microbiol 42:1012-5, 2004.
  38. Drobniewski FA, Caws M, Gibson A et al. Modern laboratory diagnosis of tuberculosis. Lancet Infect Dis 3:141-7, 2003.
  39. Campos PE, Suárez PG, Sánchez J et al. Multidrug-resistant Mycobacterium tuberculosis in HIV-infected persons, Peru. Emerg Infect Dis 9:1571-8, 2003.
  40. Almeida da Silva PE, Osorio M, Reinhardt MC et al. Drug resistance of strains of Mycobacterium tuberculosis isolated in Brazil. Microbes Infect 3:1111-3, 2001.
  41. De Pinho AM, Santoro Lopes G, Harrison LH et al. Chemoprophylaxis for tuberculosis and survival of HIV-infected patients in Brazil. Aids 15:2129-35, 2001.
  42. Casado JL, Moreno S, Fortun J et al. Risk factors for development of tuberculosis after isoniazid chemoprophylaxis in human immunodeficiency virus-infected patients. Clin Infect Dis 34:386-9, 2002.
  43. Sonnenberg P, Glynn JR, Fielding K et al. HIV and pulmonary tuberculosis: the impact goes beyond those infected with HIV. AIDS 18:657-62, 2004.
  44. De Jong BC, Israelski DM, Corbett EL et al. Clinical management of tuberculosis in the context of HIV infection. Annu Rev Med 55:283-301, 2004.
  45. Bucher HC, Griffith LE, Guyatt GH et al. Isoniazid prophylaxis for tuberculosis in HIV infection: a meta-analysis of randomized controlled trials. AIDS 13:501-7, 1999.
  46. Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society. MMWR Recomm Rep 49:1-51, 2000.
  47. Cohn DL. Treatment of latent tuberculosis infection. Semin Respir Infect 18:249-62, 2003.
  48. Update: adverse event data and revised American Thoracic Society/CDC recommendations against the use of rifampin and pyrazinamide for treatment of latent tuberculosis infection--United States, 2003. MMWR Morb Mortal Wkly Rep 52:735-9, 2003.
  49. Chaisson RE, Clermont HC, Holt EA et al. Six-month supervised intermittent tuberculosis therapy in Haitian patients with and without HIV infection. Am J Respir Crit Care Med 154:1034-8, 1996.
  50. González Montaner LJ, Natal S, Yongchaiyud P et al. Rifabutin for the treatment of newly-diagnosed pulmonary tuberculosis: a multinational, randomized, comparative study versus Rifampicin. Rifabutin Study Group. Tuber Lung Dis 75:341-7, 1994.
  51. Schwander S, Rusch-Gerdes S, Mateega A et al. A pilot study of antituberculosis combinations comparing rifabutin with rifampicin in the treatment of HIV-1 associated tuberculosis. A single-blind randomized evaluation in Ugandan patients with HIV-1 infection and pulmonary tuberculosis. Tuber Lung Dis 76:210-8, 1995.
  52. Vernon A, Burman W, Benator D et al. Acquired rifamycin monoresistance in patients with HIV-related tuberculosis treated with once-weekly rifapentine and isoniazid. Tuberculosis Trials Consortium. Lancet 353:1843-7, 1999.
  53. Okwera A, Johnson JL, Vjecha MJ et al. Risk factors for adverse drug reactions during thiacetazone treatment of pulmonary tuberculosis in human immunodeficiency virus infected adults. Int J Tuberc Lung Dis 1:441-5, 1997.
  54. Kassim S, Sassan-Morokro M, Ackah A et al. Two-year follow-up of persons with HIV-1- and HIV-2-associated pulmonary tuberculosis treated with short-course chemotherapy in West Africa. AIDS 9:1185-91, 1995.
  55. Park MM, Davis AL, Schluger NW et al. Outcome of MDR-TB patients, 1983-1993. Prolonged survival with appropriate therapy. Am J Respir Crit Care Med 153:317-24, 1996.
  56. Turett GS, Telzak EE, Torian LV et al. Improved outcomes for patients with multidrug-resistant tuberculosis. Clin Infect Dis 21:1238-44, 1995.
  57. Dean GL, Edwards SG, Ives NJ et al. Treatment of tuberculosis in HIV-infected persons in the era of highly active antirretroviral therapy. AIDS 16:75-83, 2002.
  58. Updated guidelines for the use of rifabutin or rifampin for the treatment and prevention of tuberculosis among HIV-infected patients taking protease inhibitors or nonnucleoside reverse transcriptase inhibitors. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 49:185-9, 2000.
  59. Niemi M, Backman JT, Fromm MF et al. Pharmacokinetic interactions with rifampicin : clinical relevance. Clin Pharmacokinet 42:819-50, 2003.
  60. Burman WJ, Jones BE: Treatment of HIV-related tuberculosis in the era of effective antirretroviral therapy. Am J Respir Crit Care Med 164:7-12, 2001.
  61. López Cortés LF, Ruiz-Valderas R, Viciana P et al. Pharmacokinetic interactions between efavirenz and rifampicin in HIV-infected patients with tuberculosis. Clin Pharmacokinet 41:681-90, 2002.
  62. Narita M, Ashkin D, Hollender ES et al. Paradoxical worsening of tuberculosis following antirretroviral therapy in patients with AIDS. Am J Respir Crit Care Med 158:157-61, 1998.
  63. Kunimoto DY, Chui L, Nobert E et al. Immune mediated ‘HAART’ attack during treatment for tuberculosis. Highly active antirretroviral therapy. Int J Tuberc Lung Dis 3:944-7, 1999.
  64. Loeffler AM. Pediatric tuberculosis. Semin Respir Infect 18:272-91, 2003.
  65. Cotton MF, Schaaf HS, Hesseling AC et al. HIV and childhood tuberculosis: the way forward. Int J Tuberc Lung Dis 8:675-82, 2004.
  66. Miller FJW, Seale RME, Taylor MD: Tuberculosis in children. Boston, MA, Little Brown, 1963.
  67. American Academy of Pediatrics: Tuberculosis, in LJ P (ed): Red Book Report of the Committee on Infectious Disease (ed 25th). Elk Grove Village, IL, American Academy of Pediatrics, 2000, pp 593-613.
  68. Cáceres CF. [Interventions for HIV/STD prevention in Latin America and the Caribbean: a review of the regional experience]. Cad Saude Publica 20:1468-85, 2004.
  69. WHO: Two diseases -one patient, HIV and TB -one patient, HIV and TB- once community, one patient., in WHO (ed). Geneva, 2003.
Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

 English title
 Abstract
 Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia

Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008