Diagnosis of opportunistic infections: HIV co-infections - tuberculosis.

摘要: Purpose of review Tuberculosis (TB) incidence has declined ∼1.5% annually since 2000, but continued to affect 10.4 million individuals in 2015, with 1/3 remaining undiagnosed or underreported. The diagnosis TB among those co-infected HIV is challenging as remains the leading cause death such individuals. Accurate and rapid active will avert mortality both adults children, reduce transmission, assist timeous decisions for antiretroviral therapy initiation. This describes advances diagnosing TB, especially individuals, highlights national program's uptake, impact on patient care. Recent findings diagnostic landscape been transformed over last 5 years. Molecular diagnostics Xpert MTB/RIF, which simultaneously detects Mycobacterium tuberculosis (MTB) resistance rifampicin, revolutionized control programs. WHO endorsed use MTB/RIF 2010 HIV/TB patients, later 2013 initial test all children signs symptoms pulmonary TB. Line probe assays (LPAs) are recommended detection rifampicin isoniazid sputum smear-positive specimens mycobacterial cultures. A second-line line assay extensively drug-resistant (XDR)-TB Assays urine lateral flow (LF)-lipoarabinomannan (LAM), can be used at point care (POC) have a niche role supplement seriously ill HIV-infected, hospitalized patients low CD4 cell counts less than 100 cells/μl. Polyvalent platforms m2000 (Abbott Molecular) GeneXpert (Cepheid) offer potential integration testing services. While Research Development (R&D) pipeline appears rich first glance, there actually few leads true POC tests that would allow earlier rapid, comprehensive drug susceptibility testing, when considering very high attrition rates observed between biomarker discovery product market entry. Summary In this review, we describe strategies specifically particular within past years 'disrupted' field. They lend themselves services capable polyvalent testing. Impact is, however, still debatable. What highlighted need health system strengthening case finding.