Perspectives on Advances in Tuberculosis Diagnostics, Drugs, and Vaccines

Clin Infect Dis. 2015 Oct 15;61Suppl 3(Suppl 3):S102-18. doi: 10.1093/cid/civ609.

Abstract

Despite concerted efforts over the past 2 decades at developing new diagnostics, drugs, and vaccines with expanding pipelines, tuberculosis remains a global emergency. Several novel diagnostic technologies show promise of better point-of-care rapid tests for tuberculosis including nucleic acid-based amplification tests, imaging, and breath analysis of volatile organic compounds. Advances in new and repurposed drugs for use in multidrug-resistant (MDR) or extensively drug-resistant (XDR) tuberculosis have focused on development of several new drug regimens and their evaluation in clinical trials and now influence World Health Organization guidelines. Since the failure of the MVA85A vaccine 2 years ago, there have been no new tuberculosis vaccine candidates entering clinical testing. The current status quo of the lengthy treatment duration and poor treatment outcomes associated with MDR/XDR tuberculosis and with comorbidity of tuberculosis with human immunodeficiency virus and noncommunicable diseases is unacceptable. New innovations and political and funder commitment for early rapid diagnosis, shortening duration of therapy, improving treatment outcomes, and prevention are urgently required.

Keywords: diagnostics; drugs; management; tuberculosis; vaccines.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antitubercular Agents / chemistry
  • Antitubercular Agents / classification
  • Antitubercular Agents / therapeutic use*
  • Clinical Trials as Topic
  • Extensively Drug-Resistant Tuberculosis / diagnosis
  • Extensively Drug-Resistant Tuberculosis / drug therapy
  • Extensively Drug-Resistant Tuberculosis / prevention & control
  • HIV Infections / complications
  • Humans
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics
  • Point-of-Care Systems / economics
  • Tuberculosis / complications
  • Tuberculosis / diagnosis*
  • Tuberculosis / drug therapy*
  • Tuberculosis / prevention & control
  • Tuberculosis Vaccines*
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / prevention & control
  • World Health Organization

Substances

  • Antitubercular Agents
  • MVA 85A
  • Tuberculosis Vaccines