Tuberculosis preventive therapy (TPT) to prevent tuberculosis co-infection among adults with HIV-associated cryptococcal meningitis: A clinician's perspective

John Kasibante; Morris K Rutakingirwa; Enock Kagimu; Kenneth Ssebambulidde; Jayne Ellis; Lillian Tugume; Edward Mpoza; Fiona Cresswell; David B Meya

doi:10.1016/j.jctube.2020.100180

Tuberculosis preventive therapy (TPT) to prevent tuberculosis co-infection among adults with HIV-associated cryptococcal meningitis: A clinician's perspective

J Clin Tuberc Other Mycobact Dis. 2020 Aug 13:20:100180. doi: 10.1016/j.jctube.2020.100180. eCollection 2020 Aug.

Authors

John Kasibante¹, Morris K Rutakingirwa¹, Enock Kagimu¹, Kenneth Ssebambulidde¹, Jayne Ellis^{1

2}, Lillian Tugume¹, Edward Mpoza¹, Fiona Cresswell^{2

3}, David B Meya^{1

4}

Affiliations

¹ Infectious Diseases Institute, Makerere University, Kampala, Uganda.
² Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK.
³ Medical Research Council - Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
⁴ School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Abstract

As part of the END TB strategy, the World Health organization (WHO) recommends provision of tuberculosis preventive therapy (TPT) to all people at high risk of developing active TB disease. Patients with HIV-associated cryptococcal meningitis are severely immunocompromised and therefore should be eligible for TPT. In this commentary we discuss the challenges associated with starting tuberculosis preventive therapy in patients with HIV associated cryptococcal meningitis in a clinical setting, we highlight the benefit, existing gaps and research opportunities of tuberculosis preventive therapy in this patient population.

Keywords: AIDS; Cryptococcal meningitis; Cryptococcosis; HIV; Tuberculosis; Tuberculosis preventive therapy.