Broschiertes Buch

HIV and Tuberculosis

A Formidable Alliance

Herausgegeben: Sereti, Irini; Bisson, Gregory P.; Meintjes, Graeme

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Globally, HIV-associated tuberculosis is one of the most important causes of infection-related death, accounting for one in every three HIV deaths and over 300,000 in 2017 alone. The HIV epidemic has undermined tuberculosis-control efforts in many countries around the world, as the virus has important modifying effects on the pathogenesis, diagnosis, and treatment of TB. The management of HIV-associated TB is also complicated by rapid clinical progression, immune reconstitution inflammatory syndrome, drug-drug interactions, and shared toxicities.The past two decades have yielded thousands of r...

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Irini Sereti is a Senior Investigator and Chief of the HIV Pathogenesis Section at the Laboratory of Immunoregulation at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, MD, USA. She is an Infectious Diseases trained physician with expertise in HIV and opportunistic infections including TB, doing translational research at the NIH Clinical Center where she sees patients enrolled in her clinical protocols while also conducting related laboratory research. The main focus of her research is study of people with HIV and advanced disease (low CD4 counts) and opportunistic infections, including TB, in the current antiretroviral area. She also studies inflammation in HIV infection both acutely after antiretroviral therapy initiation in the form of IRIS, but also chronically after suppression of HIV viremia, and has published papers on mycobacterial IRIS pathogenesis and imaging modalities. Her studies aim to better understand pathogenesis of HIV and severe CD4 lymphopenia with the goal to improve management of patients with late presentation to care. Graeme Meintjes is a Professor of Medicine, Wellcome Fellow and SARChI Chair of Poverty-related Infections at the University of Cape Town. He is an Infectious Diseases Physician who undertakes consultant clinical work at Khayelitsha and Groote Schuur Hospitals. His research focuses on the clinical conditions affecting patients with advanced HIV disease including disseminated HIV-associated tuberculosis, the tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) and cryptococcal meningitis. His group also investigates drug-resistant tuberculosis. He has been the PI or local PI of several clinical trials and conducts observational cohort studies that address questions related to disease pathogenesis. Recently, he was PI of the EDCTP-funded PredART trial that demonstrated that prednisone was effective and safe for the prevention of TB-IRIS in patients at high-risk starting ART. He has contributed to the development of management guidelines for HIV, TB and cryptococcal meningitis at a provincial and national level and World Health Organization Guideline Development Groups. Gregory Bisson is an Associate Professor of Medicine and an Associate Professor of Epidemiology in the School of Medicine at the University of Pennsylvania. Dr. Bisson is an Internal Medicine and Infectious Diseases Physician with expertise in the care of both HIV and TB. Dr. Bisson aims to use clinical research to improve the health of adults with advanced HIV and TB, particularly in sub-Saharan African settings. His research group has focused on relating how immune recovery on ART relates to clinical outcomes in HIV/TB, highlighting novel relationships between cellular immune function and patient outcomes including survival. Recently funded work seeks to identify immune correlates of lung damage in TB and to increaseour understanding of how manipulation of the host immune system may improve treatment outcomes in TB and HIV/TB, including via use of host-directed therapies.