Tuberculosis in immunosuppressed patients

Enferm Infecc Microbiol Clin (Engl Ed). 2018 Jun-Jul;36(6):366-374. doi: 10.1016/j.eimc.2017.10.009. Epub 2017 Dec 6.
[Article in English, Spanish]

Abstract

Tuberculosis (TB) is one of the most significant infections in immunosuppressed patients due to its high frequency and high morbidity and mortality. TB is the leading cause of death among HIV-infected patients. The diagnosis and early treatment of latent tuberculosis infection is vital to preventing it progression to disease. Similarly, the early diagnosis of TB is key to improving the prognosis of patients and preventing its transmission. The clinical expression of TB in immunosuppressed patients is conditioned by the patient's degree of immunosuppression. It is important to keep this peculiarity in mind so as not to delay the diagnosis of suspected TB. TB treatment is basically the same in immunosuppressed patients as in the general population and any differences mainly derive from pharmacological interactions. We examined the diagnosis and treatment of TB and latent tuberculosis infection in immunosuppressed patients.

Keywords: Human immunodeficiency virus; Immunosuppression; Inmunodepresión; Tuberculosis; Virus inmunodeficiencia humana.

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-HIV Agents / pharmacokinetics
  • Anti-HIV Agents / therapeutic use
  • Antitubercular Agents / pharmacokinetics
  • Coinfection
  • Drug Interactions
  • Drug Resistance
  • Early Diagnosis
  • Female
  • HIV Infections / epidemiology
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / etiology
  • Immunocompetence
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / etiology
  • Latent Tuberculosis / immunology
  • Latent Tuberculosis / prevention & control
  • Male
  • Organ Transplantation
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / immunology
  • Practice Guidelines as Topic
  • Prevalence
  • Spain / epidemiology
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis / etiology
  • Tuberculosis / immunology

Substances

  • Adrenal Cortex Hormones
  • Anti-HIV Agents
  • Antitubercular Agents
  • Immunosuppressive Agents