Speaker Details

Prof Soumya Swaminathan

Biography

Dr Soumya Swaminathan, M.B,B.S, M.D is a pediatrician by training having received her medical education at the Armed Forces Medical College, Pune and All India Institute of Medical Sciences, New Delhi. She later specialized in pediatric pulmonology at the Children’s Hospital of Los Angeles, USA. She has worked at the Tuberculosis Research Centre, Chennai for the past 16 years and is currently the Deputy Director Sr Grade and Head of the Division of HIV/AIDS at the centre. She heads a multi-disciplinary team of physicians, behavioural scientists and laboratory researchers working on the interaction between HIV and tuberculosis. She is the principal investigator for several clinical trials studying different regimens for the prevention and treatment of tuberculosis among HIV-infected patients. She is also investigating the strategy of “directly observed treatment, DOT” being used for HIV treatment, similar to its successful use in TB patients. She has been one of the pioneers in the management of HIV-infected children and has initiated studies to identify better prognostic markers for this disease. She oversees the HIV laboratory, which is involved in studies of cell-mediated immunity and pathogenesis as well as monitoring of HIV drug resistance. She has worked closely with the national TB and AIDS Control programs and is a member of the Technical Resource Group of NACO. She has over 90 publications in national and international journals.

Abstract

Tuberculosis:Comprehensive Overview and Challenges

The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV) is one of the major public health challenges of our time. The World Health Organization (WHO) reports 8.8 million new cases of TB and 1.6 million TB-related deaths in 2005, of which 195,000 were HIV-infected patients. While TB prevalence has remained stable, TB incidence continues to rise, especially in countries most severely affected by the HIV epidemic as well as those facing political turmoil, migration, poverty and unemployment and where intravenous drug abuse is rampant. Countries in sub-Saharan Africa, Eastern Europe and the former Soviet Union have seen increasing rates of TB, which have created a huge challenge for the public health programs in these countries. Further, there has been an increase in rates of drug resistant tuberculosis, including multi-drug (MDRTB) and extremely drug resistant TB (XDRTB). These forms of TB are difficult to treat and contribute to the increased mortality observed. The diagnosis of TB is based on sputum smear microscopy, a 100-year old technique and chest radiography, which has problems of specificity. Newer diagnostic tests are urgently required that are not only sensitive and specific but easy to use in remote and resource-poor settings. There have been no new drugs introduced for TB in the past 40 years and no new vaccine since BCG. Recently, there has been a major global push for development of new TB drugs and vaccines and many are now in Phase I, II and III trials. Treatment of HIV-TB coinfection is complex and associated with overlapping drug toxicities, risk of immune reconstitution inflammatory syndrome (IRIS) and challenges related to adherence. Current status of development of diagnostics, new drugs and treatment strategies will be covered as well as the challenges faced by TB control programs, world-wide.