Christoph D. Spinner

The session highlighted the global burden of TB disease. Although antiviral therapy (ART) resulted in people living with HIV (PLWH) in significantly decreased risk of extensive TB disease, improvement of diagnostic and treatment methods are urgently needed.

Gavin Churchayard introduced the importance of Mycobacterium tuberculosis (MTB) infection. While HIV-associated MTB and deaths are declining more rapidly than in HIV-negative persons, PLWH remain under a significantly increased risk of MTB infection. ART leads to a significant decline in MTB risk and does not increase infectiousness. Melvin Spigelman spoke about novel drugs and began with a historic overview from 1940s till today. Significant improvements could be demonstrated, including shorter and better tolerable MTB treatment options, including the option of safe and effective 4-month treatment course with Rifapentine-Moxifloxacin. Novel data will be presented in a late presenter session on Wednesday at IAS 2021. Finally, Claudia Denkinger lectured to diagnostics and highlighted, that approximately 2.9 million MTB cases out of approx. 10 million are not appropriately diagnosed per year. She introduced novel antigen tests for lipopolysaccharide diagnostic in mycobacteria (LAM) and underlined the need for improving triage and testing methods.

MTB is still a major global burden of disease, especially in PLWH. Major efforts are globally needed to increase and improve testing and treatment options for patients around the world and Covid-19 is endangering many MTB programs around the world. Hereby, children and special populations should be considered in all activities. While universal MTB treatment regimens are far away, improvement in diagnostic and treatment could help patients already today.