| Title | Multidrug-resistant and extensively drug-resistant tuberculosis: implications for the HIV epidemic and antiretroviral therapy rollout in South Africa. |
| Publication Type | Journal Article |
| Year of Publication | 2007 |
| Authors | Andrews, Jason R., Sarita N. Shah, Neel Gandhi, Tony Moll, and Gerald Friedland |
| Corporate Authors | Tugela Ferry Care and Research(TF CARES) Collaboration |
| Journal | The Journal of infectious diseases |
| Volume | 196 Suppl 3 |
| Pagination | S482-90 |
| Date Published | 2007 Dec 1 |
| ISSN | 0022-1899 |
| Keywords | AIDS-Related Opportunistic Infections, Antiretroviral Therapy, Highly Active, Extensively Drug-Resistant Tuberculosis, HIV Infections, Humans, South Africa, Tuberculosis, Multidrug-Resistant |
| Abstract | Drug-resistant tuberculosis (TB) is emerging as a major clinical and public health challenge in areas of sub-Saharan Africa where there is a high prevalence of human immunodeficiency virus (HIV) infection. TB drug-resistance surveillance in this region has been limited by laboratory capacity and the public health infrastructure; however, with the maturation of the HIV epidemic, the burden of drug-resistant TB is increasing rapidly. The recent discovery of large numbers of cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB in South Africa likely represents an unrecognized and evolving epidemic rather than sporadic, localized outbreaks. The combination of a large population of HIV-infected susceptible hosts with poor TB treatment success rates, a lack of airborne infection control, limited drug-resistance testing, and an overburdened MDR-TB treatment program provides ideal conditions for an MDR-TB and XDR-TB epidemic of unparalleled magnitude. In the present article, we review the history of drug-resistant TB in South Africa, describe its interaction with the HIV epidemic and the resultant consequences, and suggest measures necessary for controlling MDR-TB and XDR-TB in this context. A successful response to the emergence of MDR-TB and XDR-TB will necessitate increased resources for and collaboration between TB and HIV programs. |
| DOI | 10.3109/00952990.2011.568081 |
| Alternate Journal | J. Infect. Dis. |
