Mycobacterium tuberculosis (Mtb) infection accounts for the highest number of human deaths in low- and middle-income countries of the world. Mtb is also the most common opportunistic infection accompanying HIV infection. The death rate for combined Mtb/HIV infection is almost three-fold higher when compared to Mtb infection of HIV-seronegative patients, and the increase is not due simply to depletion of CD4 T cells due to HIV. The increased risk of mortality is due to a syndemic interaction between the two pathogens that leads to advanced immunodeficiency, chronic immune activation, and increased disease dissemination. Because of the synergy, eradication of MTB is dependent on the eradication of HIV. Though HIV/AIDS is often described as incurable, the recent “shock-and-kill” strategy to eradicate HIV holds promise for the eradication of MTB. Coinfection also amplifies transmission of multidrug-resistant tuberculosis (MDRTB), which, besides requiring longer treatment, has a very low success rate. Pending effective vaccine development, there is a need to identify newer targets for the development of drugs to treat MDRTB & XDR-TB.
M.Tuberculosis and HIV-Prolific Killers in Developing Countries are Syndemic Pathogens by M V Hosur
