Mind the gap - Managing tuberculosis across the disease spectrum.

Hanif Esmail, Liana Macpherson, Anna K Coussens, Rein M G J Houben

EBioMedicine 2022 Apr

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We currently have a binomial approach to managing tuberculosis. Those with active disease, ideally confirmed microbiologically, are treated with a standard 6-month, multi-drug regimen and those with latent infection and no evidence of disease with shorter, one or two drug regimens. Clinicians frequently encounter patients that fall between these two management pathways with some but not all features of disease and this will occur more often with the increasing emphasis on chest X-ray-based systematic screening. The view of tuberculosis as a spectrum of disease states is being increasingly recognised and is leading to new diagnostic approaches for early disease. However, the 6-month regimen for treating disease was driven by the duration required to treat the most extensive forms of pulmonary TB and shorter durations appear sufficient for less extensive disease. It is time undertake clinical trials to better define the optimal treatment for tuberculosis across the disease spectrum. Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

Citation

Hanif Esmail, Liana Macpherson, Anna K Coussens, Rein M G J Houben. Mind the gap - Managing tuberculosis across the disease spectrum. EBioMedicine. 2022 Apr;78:103928