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Chapter 49 : Tuberculosis

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Abstract:

Approximately one-third of the world’s population is thought to harbor latent forms of tuberculosis and the resultant huge reservoir for future disease. The recent increase in multidrug resistant disease and a dangerous interplay between tuberculosis and human immunodeficiency virus (HIV) infection continues to pose serious challenges for health care in the years to come. is transmitted by the inhalation of small droplet nuclei, which are aerosolized infectious particles generated by coughing, talking, and sneezing. A minority of patients with tuberculosis, who are started on highly active antiretroviral therapy (HAART) experience immune reconstitution disease (IRD) due to rapid restoration of the immune system with an increased response to mycobacterial antigens. To be valuable as a surrogate endpoint, a biomarker should measure an event that is directly involved in pathogenesis or protection and should change early during treatment. Early bactericidal activity (EBA) is used in the early evaluation of new tuberculosis drugs and is based on the rate of fall of colony-forming unit counts of (logcfu/day) in overnight sputum samples that are collected before and on alternate days of treatment, up to day 14. A host of nonspecific markers have been described that appear promising as biomarkers for tuberculosis. The extent of the tuberculosis problem that exists today represents an affront to modern society. New tools are urgently needed and only multidisciplinary approaches that include all sectors of healthcare providers and researchers stand a chance to address the problem effectively.

Citation: Walzl G, Helden P, Botha P. 2011. Tuberculosis, p 623-631. In Kaufmann S, Rouse B, Sacks D (ed), The Immune Response to Infection. ASM Press, Washington, DC. doi: 10.1128/9781555816872.ch49

Key Concept Ranking

Tumor Necrosis Factor alpha
0.4608679
Highly Active Antiretroviral Therapy
0.41175607
Nucleic Acid Amplification Techniques
0.4105556
0.4608679
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Figures

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FIGURE 1

Anteroposterior chest radiograph of an adult female with sputum culture confirmed tuberculosis with HIV coinfection (i.e., CD4 T-cell count of 274 × 10/L and not on antiretroviral treatment). There are bilateral infiltrates, right upper lobe cavitation, and right-sided pleural involvement. Courtesy of the Division of Radiology, Tygerberg Academic Hospital.

Citation: Walzl G, Helden P, Botha P. 2011. Tuberculosis, p 623-631. In Kaufmann S, Rouse B, Sacks D (ed), The Immune Response to Infection. ASM Press, Washington, DC. doi: 10.1128/9781555816872.ch49
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