Co- infection of Multidrug-resistant tuberculosis and HIV: Implication for Public Health. Review

Abstract

This article describes the current status of MDR-TB and the epidemic of MDR-TB and HIV co-infection in worldwide. TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis that transmitted through aerosol droplets and one of the world’s most devastating human pathogens that cause more than 2 million deaths annually. On the other hand, Multidrug-resistant tuberculosis (MDR-TB) caused by M. tuberculosis strains resistant to at least isoniazid (INH) and rifampin (RMP) has emerged as a significant global epidemic resulting largely from deficiencies in TB case management and program management. Subsequently, there are alarming reports of increasing drug resistance from various parts of the globe. Moreover, the most important risk factor for the development of MDR-TB is previous anti-tuberculosis therapy. Studies indicated that approximately 425,000 MDR-TB cases occur annually worldwide, representing nearly 5% of the world’s annual TB burden. On the other hand, the human immunodeficiency virus (HIV) is a driving force behind the global burden of TB and the development of drug-resistant TB. Obviously, the growing HIV infection epidemic presents massive challenges to TB control programs at all levels and could fuel further increases in anti-TB drug resistance and hence people living with HIV have a higher risk of MDR. The synergy between TB and HIV is strong; in high HIV prevalence population, TB is a leading cause of morbidity and mortality. Therefore, managing the treatment of existing cases properly is the key in prevention of the spread of MDR-TB through taking all of the medications exactly as prescribed by the healthcare providers.

Keywords: HIV, MDR-TB, Mycobacterium tuberculosis, Prevalence, Risk factor