Tuberculosis in visceral leishmaniasis-human immunodeficiency virus coinfection: an evidence gap in improving patient outcomes?

Johan van Griensven, Rezika Mohammed, Koert Ritmeijer, Sakib Burza, Ermias Diro

Research output: Contribution to journalA1: Web of Science-article

Abstract

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.

Original languageEnglish
Article numberofy059
JournalOpen Forum Infectious Diseases
Volume5
Issue number4
Number of pages4
ISSN2328-8957
DOIs
Publication statusPublished - 2018

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