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Peer reviewedOpen accessTuberculosisAIDSHIV infection

The Infectiousness of Tuberculosis Patients Coinfected with HIV

PLoS Medicine·

A. Roderick Escombe, David A. J Moore, Robert H Gilman, William Pan, Marcos Navincopa, Eduardo Ticona, Carlos Martínez, Luz Caviedes, Patricia Sheen, Armando Gonzalez, Catherine J Noakes, Jon S Friedland, Carlton A Evans

DOI
10.1371/journal.pmed.0050188
PMID
18798687
PMCID
PMC2535657
OpenAlex
W2101094926
Study type
Journal article
Publisher
Public Library of Science (PLoS)
Article type
journal-article
Integrity
current

Why this research matters now

The authors emphasise rapid drug-susceptibility testing to guide effective treatment and prioritising TB infection control and environmental measures in crowded health-care settings to prevent dissemination of drug-resistant TB.

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Structured evidence summary

Research question

The study investigates how infectiousness varies among HIV-positive pulmonary tuberculosis patients in the current era of HIV coinfection and multidrug-resistant (MDR) TB, using an airborne transmission model.

Study design

An airborne transmission study in which guinea pigs on the roof of an HIV-TB ward were exposed to exhaust air from a mechanically ventilated negative-pressure ward; transmission links were established using DNA fingerprinting, drug susceptibility testing, and the Wells-Riley model to estimate quanta of infection.

Population and setting

The setting was a mechanically ventilated negative-pressure HIV-TB ward in Lima, Perú, with 118 admissions of 97 HIV-positive pulmonary TB patients over 505 study days, and 292 guinea pigs exposed via ward exhaust air.

Main findings

Patient infectiousness was highly variable; DNA fingerprinting attributed 98% of 125 characterised cases of secondary animal TB to 8.5% of ward admissions. Approximately 90% of TB transmission originated from inadequately treated MDR TB patients, with three highly infectious MDR TB patients producing 226, 52, and 40 airborne quanta per hour.

Public-health relevance

The authors emphasise rapid drug-susceptibility testing to guide effective treatment and prioritising TB infection control and environmental measures in crowded health-care settings to prevent dissemination of drug-resistant TB.

Important limitations

This summary is limited to the supplied single-article abstract and metadata; decision-grade interpretation requires review of the original paper for detailed limitations and methodological context.

GIDS interpretation

The article is discoverable through classifiers on HIV, TB, antimicrobial resistance, and transmission dynamics. This entry provides context only and does not connect the study to any live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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