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1 July 2007 Supplement

Volume 196, Number S1
The Journal of Infectious Diseases 2007;196:S15–S27
© 2007 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2007/19604S1-0004$15.00
DOI: 10.1086/518656
SUPPLEMENT ARTICLE

Facing the Crisis: Improving the Diagnosis of Tuberculosis in the HIV Era

Mark D. Perkins1 and

Jane Cunningham2

1Foundation for Innovative New Diagnostics and 2United Nations Development Programme/United Nations Children's Fund/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland

Although the human immunodeficiency virus (HIV) infection pandemic has had a catastrophic impact on tuberculosis (TB) control efforts, especially in sub‐Saharan Africa, most of the fundamental concepts reflected in the directly observed treatment, short course (DOTS) strategy still hold true in the HIV era. What has changed, and dramatically, is the importance of speedy and accurate TB diagnosis and the difficulty of achieving this. The disproportionate amount of smear‐negative disease in sub‐Saharan Africa, which shoulders two‐thirds of the global burden of HIV infection and acquired immunodeficiency syndrome, has greatly complicated TB case detection and disease control. Now, 15 years after TB rates began to soar in countries where HIV infection is prevalent, we have learned that the conventional approach—passively waiting for patients with advanced symptomatic disease to make their way to microscopy centers for diagnosis—has disastrous consequences. Without better diagnostic tools for TB and effective strategies for their implementation, transmission will not be interrupted, mortality will not be checked, and TB will not be controlled in areas where HIV infection is prevalent. Fortunately, a number of technical opportunities exist for the creation of improved diagnostic tests. Developing and exploiting such tests to support TB control in HIV‐infected populations is an urgent priority. A substantial public sector effort is under way to work in partnership with the biotechnology industry to accelerate progress toward that goal. In this article, we will define the need for better TB tests and describe technologies being developed to meet that need.

Reprints or correspondence: Dr. Mark D. Perkins, Foundation for Innovative New Diagnostics, 71 ave. Louis Casaï, PO Box 93, 1216 Cointrin, Switzerland ().

Cited by

Keerataya Ngamlert, Chalinthorn Sinthuwattanawibool, Kimberly D. McCarthy, Hojoon Sohn, Angela Starks, Photjanart Kanjanamongkolsiri, Rapeepan Anek-vorapong, Theerawit Tasaneeyapan, Patama Monkongdee, Lois Diem, Jay K. Varma. (2009) Diagnostic performance and costs of Capilia TB for Mycobacterium tuberculosis complex identification from broth-based culture in Bangkok, Thailand. Tropical Medicine & International Health 14:7, 748-753
Online publication date: 1-Aug-2009.
CrossRef
J. Lucian Davis, Laurence Huang, Joseph A. Kovacs, Henry Masur, Patrick Murray, Diane V. Havlir, William O. Worodria, Edwin D. Charlebois, Padmini Srikantiah, Adithya Cattamanchi, Charles Huber, Yvonne R. Shea, Yuenwah Chow, and Steven H. Fischer. (2009) Polymerase Chain Reaction of secA1 on Sputum or Oral Wash Samples for the Diagnosis of Pulmonary Tuberculosis. Clinical Infectious Diseases 48:6, 725-732
Online publication date: 15-Mar-2009.
Abstract-Full Text-PDF Version (315 kB)
Sheela Shenoi, Scott Heysell, Anthony Moll, Gerald Friedland. (2009) Multidrug-resistant and extensively drug-resistant tuberculosis: consequences for the global HIV community. Current Opinion in Infectious Diseases 22:1, 11-17
Online publication date: 1-Mar-2009.
CrossRef
Alma Tostmann, Sandra V. Kik, Nico A. Kalisvaart, Maruschka M. Sebek, Suzanne Verver, Martin J. Boeree, and Dick van Soolingen. (2008) Tuberculosis Transmission by Patients with Smear‐Negative Pulmonary Tuberculosis in a Large Cohort in The Netherlands. Clinical Infectious Diseases 47:9, 1135-1142
Online publication date: 1-Nov-2008.
Abstract-Full Text-PDF Version (305 kB)
Daphne I Ling, Alice A Zwerling, Madhukar Pai. (2008) Rapid diagnosis of drug-resistant TB using line probe assays: from evidence to policy. Expert Review of Respiratory Medicine 2:5, 583-588
Online publication date: 1-Nov-2008.
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Paul Yager, Gonzalo J. Domingo, John Gerdes. (2008) Point-of-Care Diagnostics for Global Health. Annual Review of Biomedical Engineering 10:1, 107-144
Online publication date: 1-Sep-2008.
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Nicole Parrish, Karen Carrol. (2008) Importance of improved TB diagnostics in addressing the extensively drug-resistant TB crisis. Future Microbiology 3:4, 405-413
Online publication date: 1-Sep-2008.
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Graeme Meintjes, Lut Lynen. (2008) Prevention and treatment of the immune reconstitution inflammatory syndrome. Current Opinion in HIV and AIDS 3:4, 468-476
Online publication date: 1-Aug-2008.
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Luca Richeldi, Monica Losi, Stefania Cerri, Lucio Casali, Leonardo M Fabbri, Giovanni Ferrara. (2008) Using ELISpot technology to improve the diagnosis of tuberculosis infection: from the bench to the T-SPOT.TB assay. Expert Review of Respiratory Medicine 2:2, 253-260
Online publication date: 1-May-2008.
CrossRef
Douglas B. Young, Mark D. Perkins, Ken Duncan, Clifton E. Barry. (2008) Confronting the scientific obstacles to global control of tuberculosis. Journal of Clinical Investigation 118:4, 1255-1265
Online publication date: 1-May-2008.
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Madhukar Pai, Daphne I Ling. (2008) Rapid diagnosis of extrapulmonary tuberculosis using nucleic acid amplification tests: what is the evidence?. Future Microbiology 3:1, 1-4
Online publication date: 1-Mar-2008.
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Robert M Grant. (2007) Research in situ. Nature Methods 4:11, 887-890
Online publication date: 1-Dec-2007.
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Gavin J. Churchyard, Fabio Scano, Alison D. Grant, and Richard E. Chaisson. (2007) Tuberculosis Preventive Therapy in the Era of HIV Infection: Overview and Research Priorities. The Journal of Infectious Diseases 196:s1, S52-S62
Online publication date: 1-Jul-2007.
Abstract-Full Text-PDF Version (312 kB)
Gerald Friedland, Gavin J. Churchyard, and Edward Nardell. (2007) Introduction: Tuberculosis and HIV Coinfection: Current State of Knowledge and Research Priorities. The Journal of Infectious Diseases 196:s1, S1-S3
Online publication date: 1-Jul-2007.
Citation-Full Text-PDF Version (183 kB)

  • Potential conflicts of interest: none reported.

    Financial support: supplement sponsorship is detailed in the Acknowledgments.

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