AIDS and Tuberculosis: A Deadly Liaison (Infection Biology Handbook Series)

AIDS and Tuberculosis: A Deadly Liaison......Page 5 Contents......Page 7 Preface......Page 15 List of Contributors......Page 19 Part One: Immunology and Vaccination Strategies for AIDS and TB......Page 23 1.2 Challenges for HIV Vaccine Design......Page 25 1.3 What Immune Responses will be Required for an Effective AIDS Vaccine?......Page 27 1.3.1 Cytotoxic T Lymphocytes......Page 28 1.3.2 Neutralizing Antibodies......Page 30 1.3.3 CD4+ T Helper Cells......Page 31 1.4 Models of Successful Vaccination?......Page 32 1.5 Human Trials of AIDS Vaccines......Page 33 1.5.2.1 The STEP Study......Page 34 1.6 Recent Advances in Animal Models: Reasons for Optimism......Page 35 1.6.2 Heterologous rAd26 Prime/rAd5 Boost Vaccine Regimen......Page 36 1.7.1 DNA......Page 37 1.7.3 Peptides......Page 38 1.7.5.1 Listeria monocytogenes......Page 39 1.7.6 Canarypox......Page 40 1.8 Conclusions and Future Directions......Page 41 References......Page 42 2 Immune Response to Tuberculosis as a Basis for Rational Vaccination Strategies......Page 53 2.2 Clinical Aspects of TB......Page 54 2.3 Immune Response to TB: Innate Immunity......Page 56 2.4.1 T-Cell Subsets......Page 58 2.5.1 IL-12 Family of Cytokines......Page 60 2.6.1 From the Past to the Present......Page 62 2.6.2.1 Goals of Vaccination......Page 64 2.6.2.2 Vaccination Strategies......Page 66 2.7 Biomarkers......Page 68 2.7.2 Transcriptomics......Page 70 2.8 Concluding Remarks......Page 71 References......Page 72 3.1 Bacillus Calmette-Guérin (BCG) and its Efficacy in Healthy Infants......Page 77 3.2 Adverse Events Caused by BCG in Healthy Infants......Page 78 3.3 Specific Immunity Induced by BCG in Healthy Infants......Page 80 3.4 Efficacy of BCG to Prevent TB in HIV-Infected Infants......Page 82 3.5 Adverse Effects Caused by BCG in HIV-Infected Infants not Receiving Antiretroviral Therapy......Page 83 3.6 BCG Immune Reconstitution Inflammatory Syndrome (BCG-IRIS)......Page 84 3.7 Management of BCG Disease in HIV-Infected Infants......Page 85 3.8 Specific Immunity Induced by BCG in HIV-Infected Infants......Page 86 3.9 Weighing up the Evidence: Should BCG be given to HIV-Infected or HIV-Exposed Infants?......Page 87 3.10 How Can We Protect HIV-Infected Infants Against TB, if BCG is Not Given?......Page 88 3.11 BCG Vaccination of HIV-Exposed, Uninfected Infants......Page 89 References......Page 91 Part Two: Drugs......Page 97 4.1 Introduction......Page 99 4.2 Nucleoside Analogue Reverse Transcriptase Inhibitors (NRTIs)......Page 103 4.3 Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)......Page 106 4.4 HIV Protease Inhibitors......Page 108 4.5.1 Entry Inhibitors......Page 112 4.5.2 Integrase Inhibitors......Page 113 4.6 Newer Strategies......Page 115 4.7 Concomitant Treatment of HIV Infection and Tuberculosis......Page 116 References......Page 117 5.1 Introduction......Page 125 5.2 Genetic Aspects of Drug Resistance......Page 126 5.3 Principles of Drug Susceptibility Testing in the Laboratory......Page 130 5.4 Clinical Implications of Drug Resistance......Page 133 5.5 Outlook and Perspectives......Page 136 References......Page 137 6.1 Important Concepts and Definitions......Page 145 6.3 Current Therapy for TB and AIDS......Page 146 6.4 Potential Drug–Drug and Drug–Disease Interactions......Page 147 6.5 Treatment of Tuberculosis......Page 148 6.5.1 Rifampin......Page 149 6.5.4 Isoniazid......Page 152 6.5.7 Fluoroquinolones......Page 153 6.5.9 Terizidone/Cycloserine......Page 154 6.5.13 Clarithromycin......Page 155 6.6.3.1 Oral Bioavailability of Delavirdine and PIs......Page 156 6.7.2.1 Rifamycins......Page 159 6.7.2.1.2 Rifampin + NNRTI......Page 160 6.7.2.1.3 Rifampin + PI......Page 162 6.8.1 TB Drugs in Development, and Potential Interactions......Page 163 6.8.3.1 Antituberculosis Drugs and Oral Hypoglycemic Agents......Page 164 6.8.3.2 Antituberculosis Agents and Prednisolone......Page 165 References......Page 166 Part Three Clinical Issues......Page 177 7.1 Introduction......Page 179 7.2.1.1 HIV Testing for Prevention......Page 180 7.2.1.2 Earlier Entry to Care......Page 181 7.3 Methods of Testing......Page 182 7.3.1 ELISA......Page 184 7.3.3 Western Blot......Page 185 7.4.1 Assessment of Baseline HIV Parameters......Page 186 7.4.2.1 Tuberculosis......Page 187 7.4.2.3 Viral Hepatitis......Page 189 7.4.2.4 Other Infections......Page 190 7.4.4 Adherence Assessment......Page 192 7.5.1.1 Asymptomatic Patients......Page 193 7.5.1.2 Patients with Tuberculosis......Page 194 7.5.1.4 Primary HIV Infection......Page 195 7.5.2.1 Backbone: Nucleoside Reverse Transcriptase Inhibitors......Page 196 7.5.2.2 Anchor: Non-Nucleoside Reverse Transcriptase Inhibitors or Protease Inhibitors......Page 199 7.5.3 Monitoring......Page 200 7.6 Summary and Conclusions......Page 201 References......Page 202 8.2 Epidemiology of Tuberculosis in HIV-Infected Persons......Page 213 8.3.1 Latent Tuberculosis Infection......Page 214 8.3.1.1.1 The Tuberculin Skin Test......Page 215 8.3.1.1.2 The Interferon-Gamma Release Assay......Page 216 8.3.1.2.3 Four-Month Regimens......Page 217 8.3.2.1.1 Clinical Presentation......Page 218 8.3.2.1.3 Sputum Smear and Culture......Page 219 8.3.2.2.1 The Drug Regimen......Page 220 8.3.2.2.2 Drug Combinations and Interactions......Page 221 8.3.2.2.4 Duration of Therapy......Page 223 8.3.2.2.5 Immune Reconstitution Inflammatory Syndrome (IRIS)......Page 224 References......Page 225 9.1 Introduction......Page 231 9.2.1 Global Epidemiology of HIV/TB Coinfection and Disease: Estimates and Regional Time Trends......Page 237 9.2.1.1.1 The Example of Sub-Saharan Africa......Page 238 9.2.2 HIV as a Risk Factor for TB in the Pre- and Post-ART Era......Page 240 9.2.3 The Secondary Impact of HIV-Related TB on Global TB Transmission Rates and Population Genetics of M. tuberculosis......Page 241 9.2.3.1 HIV and TB Transmission Rates at the Community Level......Page 242 9.2.3.2 HIV and Institutional TB Transmission......Page 244 9.2.4 The Impact of Pathogen and Host Genetics on Disease Outcome in TB/HIV Coinfection......Page 245 9.2.4.1 The Impact of HIV Subtype Specificity on HIV Regulation and Disease Outcome in TB/HIV Coinfection......Page 246 9.2.4.3 The Impact of Host Variability and Disease Outcome on TB/HIV Coinfection......Page 247 9.3 Clinical Aspects of TB Disease in the HIV-Infected Patient......Page 248 9.3.1 Chronic Cough and other Common Clinical Presentations of HIV/TB......Page 249 9.3.3 Excluding TB in the Context of HIV Care......Page 251 9.3.4 Treatment of Latent TB, and Preventive Therapy......Page 252 9.4 Treatment of HIV-Infected TB Patients......Page 253 9.4.2 Antituberculosis Regimens......Page 254 9.4.3 Choice of Antiretrovirals in the Context of Treating TB......Page 255 9.4.4 When to Start ART?......Page 256 9.4.5 Immune Reconstitution in TB/HIV Coinfection......Page 257 9.5.1 An Example of Linking TB and HIV/AIDS Care at the Community Level......Page 261 9.6 Conclusions......Page 263 References......Page 264 10.1 Introduction......Page 275 10.2 The Burden of XDR TB and HIV......Page 276 10.4 Mechanisms by which HIV may Lead to Drug Resistance in TB......Page 277 10.4.1 Acquired Resistance......Page 279 10.4.2 Primary Resistance......Page 281 10.5 Role of HIV on the Infectiousness of XDR TB......Page 283 10.7.1 Diagnosis......Page 284 10.7.2 Treatment......Page 285 References......Page 289 11.1.1 Introduction......Page 299 11.1.2 Pathogenesis......Page 300 11.2.1 Case Definitions and Diagnostic Criteria......Page 302 11.2.2 Epidemiology......Page 303 11.2.3 Clinical Manifestations......Page 305 11.2.4 Management......Page 306 11.2.5 Prevention......Page 307 References......Page 308 Index......Page 313