HIV-Mycobacterium tuberculosis co-infection: a 'danger-couple model' of disease pathogenesis.
Tuberculosis (TB) and human immunodeficiency virus (HIV) infection interfere and impact the pathogenesis phenomena of each other. Owing to atypical clinical presentations and diagnostic complications, HIV/TB co-infection continues to be a menace for healthcare providers. Although the increased access to highly active antiretroviral therapy (HAART) has led to a reduction in HIV-associated opportunistic infections and mortality, the concurrent management of HIV/TB co-infection remains a challenge owing to adverse effects, complex drug interactions, overlapping toxicities and tuberculosis -associated immune reconstitution inflammatory syndrome. Several hypotheses have been put forward for the exacerbation of tuberculosis by HIV and vice versa supported by immunological studies. Discussion on the mechanisms produced by infectious cofactors with impact on disease pathology could shed light on how to design potential interventions that could decelerate disease progression. With no vaccine for HIV and lack of an effective vaccine for tuberculosis, it is essential to design strategies against HIV-TB co-infection.
Tropical Infectious Disease Research and Education Center (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia.
Esaki M
EM
Shankar
Ramachandran
R
Vignesh
Rada
R
Ellegård
Muttiah
M
Barathan
Yee K
YK
Chong
M Kahar
MK
Bador
Devi V
DV
Rukumani
Negar S
NS
Sabet
Adeeba
A
Kamarulzaman
Vijayakumar
V
Velu
Marie
M
Larsson
D060085:Coinfection / Q000188:drug therapy / Q000473:pathology*; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*
HIV; PD-1; co-infection; immunomodulation; tuberculosis; virulence