Recent developments in epidemiology, treatment, and diagnosis of tuberculosis

The resurgence in cases of active tuberculosis in North America in the past decade has prompted increases in funding for tuberculosis treatment, research, and education. As a result, the number of new cases of tuberculosis has declined and cases occur in smaller pockets of well-characterized populations, such as communities of foreign-born persons and socioeconomically disadvantaged groups. New strategies for the treatment of both active and latent tuberculosis may soon include the newly licensed, long-acting rifamycin, rifapentine, but further studies are needed to determine optimal dosing regimens for this agent. Experts in tuberculosis and HIV infection have made headway in defining the optimal therapy for each current therapeutic option, and recently published guidelines are a useful document for clinicians. Rifabutin-based regimens are one approach toward achieving the optimal treatment of both diseases simultaneously. Finally, newly licensed molecular diagnostic tests for direct use on clinical specimens are intriguing, but their clinical utility remains to be defined.