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The situation is particularly worrisome in countries with high or intermediate <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> burden against the background of a variable <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> epidemic state. Early diagnosis of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> disease in an <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected person is paramount but suffers from lack of sensitive and specific diagnostic tools. Enhanced symptom screening is currently advocated, and the wide application of affordable molecular diagnostics is urgently needed. Treatment of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> co\u2010infection involves the concurrent use of standard antiretrovirals and antimycobacterials during which harmful drug interaction may occur. The pharmacokinetic interaction between rifamycin and antiretrovirals is a case in point, requiring dosage adjustment and preferential use of rifabutin, if available. Early initiation of antiretroviral therapy is indicated, preferably at 2 weeks after starting <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> treatment for patients with a <jats:styled-content style=\"fixed-case\">CD4<\/jats:styled-content> of &lt;50 cells\/\u03bc<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>. Development of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010immune reconstitution inflammatory syndrome (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IRIS<\/jats:styled-content>) is however more frequent with early antiretroviral therapy. The diagnosis of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IRIS<\/jats:styled-content> is another clinical challenge, and cautious use of corticosteroids is suggested to improve clinical outcome. As a preventive measure against active <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> disease, the screening for latent <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> infection should be widely practiced, followed by at least 6\u20139 months of isoniazid treatment. To date tuberculin skin test remains the only diagnostic tool in high <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> burden countries. The role of alternative tests, for example, interferon\u2010\u03b3 release assay, would need to be better defined for clinical application.<\/jats:p>","DOI":"10.1111\/resp.12120","type":"journal-article","created":{"date-parts":[[2013,5,20]],"date-time":"2013-05-20T10:14:40Z","timestamp":1369044880000},"page":"912-922","source":"Crossref","is-referenced-by-count":18,"title":["Management of tuberculosis and latent tuberculosis infection in human immunodeficiency virus\u2010infected persons"],"prefix":"10.1111","volume":"18","author":[{"given":"Shui Shan","family":"Lee","sequence":"first","affiliation":[{"name":"Stanley Ho Centre for Emerging Infectious Diseases The Chinese University of Hong Kong  Hong Kong"},{"name":"Department of Microbiology The Chinese University of Hong Kong  Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graeme","family":"Meintjes","sequence":"additional","affiliation":[{"name":"University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeeba","family":"Kamarulzaman","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Research in AIDS (CERiA) University of Malaya  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Chiu","family":"Leung","sequence":"additional","affiliation":[{"name":"Tuberculosis and Chest Service Department of Health  Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,7,25]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"484","article-title":"CDC Grand Rounds: the TB\/HIV syndemic","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb. 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