{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:36:33Z","timestamp":1791218193909,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T00:00:00Z","timestamp":1461542400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2016,4]]},"abstract":"The symbiotic association of tuberculosis (TB<\/jats:styled-content>) and HIV<\/jats:styled-content> poses a challenge to human survival. HIV<\/jats:styled-content> complicates every aspect of TB<\/jats:styled-content> including presentation, diagnosis and treatment. HIV<\/jats:styled-content>\u2013TB<\/jats:styled-content> patients encounter unique problems like drug\u2013drug interactions, cumulative toxicity, immune reconstitution inflammatory syndrome (IRIS<\/jats:styled-content>), lower plasma drug levels and emergence of drug resistance during treatment despite adherence. TB<\/jats:styled-content> may also be overdiagnosed in HIV<\/jats:styled-content> due to a number of diseases that closely resemble TB<\/jats:styled-content>. Notable among them are non\u2010tuberculous mycobacteria, Pneumocystis Jirovecii and Nocardia. Even though diagnostic procedures have improved over the years, patients in developing countries usually seek health care at later stage of the disease. Research data ascertains the duration of therapy for TB<\/jats:styled-content> to be 6\u00a0months with rifampicin and isoniazid, reinforced with ethambutol and pyrazinamide in the first 2\u00a0months. The schedule of therapy is still debatable with daily regimens being preferred in the context of HIV<\/jats:styled-content>. Many reasons exist for persistence of Mycobacterium Tuberculosis<\/jats:italic> (M.TB<\/jats:styled-content>) in sputum, or delayed\u2010clearance of TB<\/jats:styled-content> from sputum smears in HIV<\/jats:styled-content>, apart from emergence of drug resistance and non\u2010compliance. Acquired rifampicin resistance (ARR<\/jats:styled-content>) is a unique phenomenon complicating HIV<\/jats:styled-content>\u2010associated TB<\/jats:styled-content> when an intermittent regimen of antituberculosis therapy (ATT<\/jats:styled-content>) is used without timely initiation of highly active antiretroviral therapy (HAART<\/jats:styled-content>), especially in patients harbouring isoniazid\u2010resistant strains Immune restoration is often incomplete (\u2018swiss cheese\u2019 pattern) even with effective HAART<\/jats:styled-content> if not started early. Immune reconstitution inflammatory syndrome (IRIS<\/jats:styled-content>) is the paradoxical worsening of the patient's condition often with radiological deterioration, due to an enhanced immune response with HAART<\/jats:styled-content>. IRIS<\/jats:styled-content> occurs despite an effective virological suppression and a favourable response to ATT<\/jats:styled-content>. The incidence of IRIS<\/jats:styled-content> in HIV<\/jats:styled-content> has reached up to 54%, requiring utilization of experts and tertiary care which forms an obstacle to the decentralization of patients in the ART<\/jats:styled-content> programme. Research in HIV<\/jats:styled-content>\u2013TB<\/jats:styled-content> immunology and management needs further exploration in order to understand the\u00a0diseases and offer appropriate treatment. The following paragraphs provide scientific evidences generated through research that could potentially guide management.<\/jats:p>","DOI":"10.1111\/odi.12389","type":"journal-article","created":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T05:31:03Z","timestamp":1461562263000},"page":"46-52","source":"Crossref","is-referenced-by-count":19,"title":["TB<\/scp>\u2013HIV<\/scp> co\u2010infection: a catastrophic comradeship"],"prefix":"10.1111","volume":"22","author":[{"given":"G","family":"Narendran","sequence":"first","affiliation":[{"name":"National Institute for Research in Tuberculosis Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Swaminathan","sequence":"additional","affiliation":[{"name":"National Institute for Research in Tuberculosis Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014181"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis630"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000202648.18526.bf"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/425742"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328358daea"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2003.12.002"},{"key":"e_1_2_9_8_1","unstructured":"CamineroJA(2006).Diagnosis of the MDR Diagnosis of the MDR\u2014TBTB Case Findings Strategies.ftp:\/\/ftp.cdc.gov\/pub\/nchstp\/tb\/WHO_CC_Latvia\/present\/7%20Caminero.%20Diagnosis%20and%20Case%20Finding%20Srategies.pdfcaminero"},{"key":"e_1_2_9_9_1","first-page":"1","article-title":"Guidelines for the use and safety monitoring of bedaquiline fumarate (Sirturo) for the treatment of multidrug\u2010resistant tuberculosis","volume":"62","author":"Centers for Disease Control and Prevention","year":"2013","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_9_10_1","first-page":"946","article-title":"Tuberculosis immune reconstitution inflammatory syndrome in countries with limited resources","volume":"10","author":"Colebunders R","year":"2006","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_9_11_1","unstructured":"DHHS(2014).Guidelines for the use of antiretroviral agents in HIV\u20101\u2010infected adults and adolescents. 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