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Adult tuberculosis in the 21st century: pathogenesis, clinical features, and management

Wallis, Robert S. MD; Johnson, John L. MD

Current Opinion in Pulmonary Medicine: May 2001 - Volume 7 - Issue 3 - p 124-132
Infectious diseases

This article reviews the significant advances in the past year in the basic and clinical aspects of adult tuberculosis (TB). Further research has deepened our understanding of host susceptibility and resistance mechanisms, including cytotoxicity, apoptosis, and antimicrobial polypeptides such as granulysin. Studies have confirmed the effects of HIV infection on risk of disease and disease manifestations, and have defined the effects of HIV on TB transmission. Recent studies also indicate a possible role for extended treatment of active disease and latent infection in HIV-1 infected individuals. Multidrug-resistant disease has been reported on every continent; rapid molecular approaches to the simultaneous diagnosis of TB and detection of rifampin resistance may facilitate prompt initiation of treatment. TB remains one of the major problems in global health.

*UMDNJ - NJ Medical School, Newark, New Jersey; and Case Western Reserve University, Cleveland, Ohio, USA.

Correspondence to John L. Johnson, MD, Division of Infectious Diseases, Case Western Reserve University School of Medicine, Room E-202 Tuberculosis Research Unit, 10900 Euclid Avenue, Cleveland, OH 44106-4984, USA: e-mail:

Copyright © 2001 Wolters Kluwer Health, Inc. All rights reserved.