title: Unmasking tuberculosis in the era of antiretroviral treatment.
abstract: Tuberculosis (TB) can develop soon after antiretroviral treatment initiation, as the result of restoration of the anti-TB specific immune response. This form of the disease is often defined as "unmasked TB", and it represents a major challenge for severely immune-suppressed HIV-infected subjects initiating treatment. Emergence of previously unrecognised TB disease occurs frequently in countries where TB/HIV co-infection is common, and where antiretroviral treatment has become increasingly accessible. The challenges posed by unmasked TB, such as its high incidence, the lack of reliable diagnostic tools and the uncertainties on its optimal management, may hamper our ability to face the TB/HIV epidemic. Therefore, unmasked TB appears a major threat to global health and poses additional barriers to successful HIV/AIDS care and treatment programmes. This review focuses on the epidemiology, immunopathogenesis and clinical manifestations of unmasked TB, and provides evidence-based recommendations for management and care of the disease.
authors: Clinic of Infectious Diseases, San Gerardo de' Tintori Hospital, via Pergolesi 33 20900 Monza, Italy. g.lapadula@hsgerardo.org
authors: Giuseppe
authors: G
authors: Lapadula
authors: Alessandro
authors: A
authors: Soria
authors: Alessandra
authors: A
authors: Bandera
authors: Nicola
authors: N
authors: Squillace
authors: Francesca
authors: F
authors: Sabbatini
authors: Fabio
authors: F
authors: Franzetti
authors: Giovanni Battista
authors: GB
authors: Migliori
authors: Andrea
authors: A
authors: Gori
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents