Combined therapy for tuberculosis and HIV-1: the challenge for drug discovery

• Published in: Drug discovery today Vol. 12; no. 21; pp. 980 - 989
• Main Authors: Pepper, Dominique J., Meintjes, Graeme A., McIlleron, Helen, Wilkinson, Robert J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-11-2007; Elsevier Science
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Anti-HIV Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antitubercular Agents - therapeutic use; Antiviral agents; Bacillus; Biological and medical sciences; Drug Design; Drug Interactions; Drug Resistance, Bacterial; Drug Resistance, Viral; HIV-1; Human immunodeficiency virus 1; Humans; Immune Reconstitution Inflammatory Syndrome - etiology; Medical sciences; Mycobacterium tuberculosis; Pharmacology. Drug treatments; Tuberculosis - drug therapy; Antiretroviral agent; Drug combination; HIV-1 virus; Retroviridae; Mycobacterial infection; Review; Lentivirus; Infection; Virus; Concomitant disease; Tuberculosis; Bacteriosis; Antiviral; Antituberculous agent; Drug interaction; Combined treatment; Human immunodeficiency virus
• ISSN: 1359-6446; 1878-5832
• DOI: 10.1016/j.drudis.2007.08.001

Combining drug therapies for dual infection by
Mycobacterium tuberculosis and HIV-1 is made complex by high pill burdens, shared drug toxicities, drug–drug and drug–disease interactions, immune reconstitution inflammatory syndrome, co-morbid diseases and drug resistance in both bacillus and virus. Recently, novel anti-tubercular and anti-retroviral drugs have bolstered the tuberculosis–HIV drug pipelines and may help ameliorate these difficulties. This review article discusses the reasons for current problems of therapy for dual infection. It also identifies promising agents, which may significantly improve co-therapy and thus diminish the great morbidity and mortality of these two pandemics.