IAS 2017: X-DR TB emerges in 1990s in South Africa fueled by HIV

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Science Speaks is in Paris this week covering the 9th IAS Conference on HIV Science.

PARIS – Extensively drug resistant tuberculosis emerged and was widely transmitted in South Africa long before it was spotted by public health surveillance efforts, and at least a decade earlier than the first reported outbreak in 2005, a  presentation Monday showed. The start of the spread was , concurrent with the steep rise in both HIV and TB incidence in the early 1990s.

The analysis of genomic sequencing of cases in KwaZulu-Natal provice, presented by Tyler Brown an infectious diseases fellow at Massachusetts General Hospital, was similar to that undertaken to determine the timing of the introduction of the HIV virus into North America.

Extensively drug-resistant tuberculosis is defined as TB that is resistant to the two major anti-tuberculosis medications, isoniazid and rifampicin as well as two additional categories of TB drugs and has a mortality rate of 50- to – 80 percent.  South Africa has the highest rate of XDR-TB in the world with more than 1,000 cases reported in 2015.

“Evolution of drug resistance happens fast even in tuberculosis and whole genomic sequencing can be an important tool for early detection of emerging drug resistance,” Brown said. He called for immediate surveillance to monitor the potential emergence of resistance to the new medications, Bedaquiline and Delamanid.  He also noted that HIV likely facilitated the introduction and spread of XDR-TB.  “HIV treatment is likely a cornerstone to preventing further spread of XDR-TB,” he concluded.

One thought on “IAS 2017: X-DR TB emerges in 1990s in South Africa fueled by HIV

  1. Muguwa Joseph

    And just a few days ago, on BBC News, it is was announced that “some technical investigations” have revealed that it is okay for “patients feeling well to withdraw from prescribed anti-biotic treatments”!!!. Allegedly, to prevent increases in drug resistance!!!!,. This is really terrible and quite unethical. Good that one of the renowned and highly-placed figure expressed his utmost doubt on this and condemned it, thereafter. He further urged for thorough and technically-convincing investigations to be undertaken before such utterances. What a shame, and especially, when the the whole world is struggling against the ever-increasing anti-biotic resistance. We further know very well that this non-adherence/and or under-dose e,t,c, are some of the major contributory factors in inducing resistance. Are they conspiring with the pharmaceutical companies? Shame, once more!!


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