Bedaquiline combined with other active drugs has the potential to achieve high culture conversion rates in advanced MDR- and XDR-TB cases. However, it is crucial to follow carefully all patients for severe adverse events, even after bedaquiline discontinuation.

New research published in the online edition of Clinical Infectious Diseases supports World Health Organization (WHO) recommendations for the use of drug susceptibility testing to select drugs for the treatment of drug-resistant tuberculosis. Drug susceptibility testing for ethambutol, pyrazinamide and second-line anti-tuberculosis (TB) treatment was shown to provide clinically useful information for the selection of treatment regimens for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The chances of treatment success were increased between 1.7 and 4.6-fold when susceptibility testing showed that the use of an individual agent was appropriate.

HIV-negative individuals are an important source of new tuberculosis (TB) cases in HIV-positive patients, according to a study conducted in a South African township published in the online edition of the Journal of Infectious Diseases.

HIV infection is associated with an increased risk of multi-drug-resistant tuberculosis (MDR-TB), results of a systematic review and meta-analysis published in PLOS ONE show. HIV increased the risk of MDR-TB by 24%. The analysis included 24 separate studies with a total patient population of 93,000. The investigators believe their findings have important implications for TB control programmes in terms of detection, appropriate treatment, infection control and follow-up.

Cotrimoxazole prophylaxis has no impact on incidence or detection of tuberculosis (TB) in people with HIV, a study published PLoS One shows. The prospective, observational study involved 2393 adult participants in Soweto, South Africa. All had a CD4 cell count below 350 cells/mm³. Participants taking cotrimoxazole prophylaxis actually had a higher risk of TB compared to participants not taking the treatment. But the authors believe this was due to residual confounding. Prophylaxis with the drug did not compromise TB diagnosis and had a protective effect in term of overall mortality.

A low CD4 cell count increases the risk of immune reconstitution inflammatory syndrome (IRIS) for people starting antiretroviral therapy (ART) within two weeks of treatment for tuberculosis (TB), investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. The timing of antiretroviral therapy had no impact on the risk of IRIS for people with a CD4 count above 50 cells/mm³. 

Simultaneous treatment with anti-tuberculosis (TB) drugs and antiretroviral therapy (ART) does not result in major changes in liver function, investigators report in the International Journal of Infectious Diseases.

Approximately 25% of people with multidrug-resistant tuberculosis (MDR-TB) in the UK are not completing the recommended course of treatment, data published in the 3 October edition of Eurosurveillance shows. Treatment was completed by 71% of patients in 24 months or more, which was below both the World Health Organization (WHO) and UK targets (75 and 85%, respectively).

Rates of AIDS-defining illnesses in the first year of antiretroviral therapy are significantly higher among migrant than non-migrant populations in resource-rich countries, investigators report in the online edition of AIDS. The difference was mainly driven by higher rates of tuberculosis (TB) among migrant populations. The results of the study show the importance of screening people for TB before commencing HIV therapy, say the investigators.

Incidence of tuberculosis (TB) among HIV-positive heterosexual people in England and Wales declined significantly between 2002 and 2010, investigators report in the online edition of AIDS. The fall is attributed to changes in the epidemiology of HIV in the UK and increased uptake of antiretroviral therapy. The vast majority of TB diagnoses – 84% – involved people from sub-Saharan Africa.