• Users Online: 338
  • Home
  • Print this page
  • Email this page
REVIEW ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 1  |  Page : 1-6

Patients at high risk of tuberculosis recurrence


1 Department of Veterans Affair, Miami VA Medical Center; Department of Medicine, Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA
2 Department of Veterans Affairs, Atlanta VAMC, Decatur; Department of Medicine, Division of Pulmonary and Critical Care, University of Emory, Atlanta, GA, USA

Correspondence Address:
Dr Ruxana T Sadikot
Emory University School of Medicine, Atlanta, GA 30033
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmy.ijmy_164_17

Rights and Permissions

Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1586    
    Printed84    
    Emailed1    
    PDF Downloaded464    
    Comments [Add]    
    Cited by others 2    

Recommend this journal