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Tuberculosis (TB), a disease that has plagued humanity for centuries, may be on the verge of significant change. Recent advancements in treatment, diagnosis, and understanding the disease’s progression are offering hope for a future with shorter, more effective treatments and faster, more accessible testing.

For decades, TB treatment was a grueling process, involving lengthy courses of multiple drugs with harsh side effects. However, groundbreaking research, much of it supported by the National Institutes of Health (NIH) and conducted by scientists at UC San Francisco (UCSF) and other institutions, is revolutionizing the fight against TB.

Shorter, More Effective Treatments

One of the most significant developments is the reduction in treatment time. Landmark studies, including a 2021 study co-led by UCSF scientists, have demonstrated that drug-susceptible TB can be effectively treated in just four months, nearly half the previous duration. For drug-resistant TB, treatment has been shortened to six months with oral medications, a significant improvement over the previous two-year regimen involving injections.

“People are more likely to finish shorter treatment courses, which makes them more effective and guards against the development of drug resistance,” explains Payam Nahid, MD, MPH, Executive Director of UCSF’s Institute for Global Health Sciences. “Symptoms improve more quickly and people become less infectious sooner, reducing new infections.”

Furthermore, research suggests that many patients are being treated with regimens designed for the most severe cases, when shorter, less intense treatments would suffice. This “Goldilocks” approach, tailoring treatment to the individual, is expected to become more prevalent in the coming years.

Revolutionizing Diagnosis

Diagnosing TB has historically been a time-consuming and resource-intensive process, often relying on microscopy or sophisticated laboratory tests. However, researchers are leveraging advancements made during the COVID-19 pandemic to develop faster, more accessible diagnostic tools.

Adithya Cattamanchi, MD, division chief of pulmonary diseases and critical care medicine at UC Irvine and a member of the UCSF Center for TB, is working to develop low-cost, swab-based molecular tests that can be used in community settings. Research is also underway to improve urine-based tests and develop blood tests for TB.

Unraveling the Mystery of TB Progression

One of the most perplexing aspects of TB is why only a fraction of those exposed to the bacteria develop active disease. Sara Suliman, Ph.D., MPH, Assistant Professor of Medicine, is researching biomarkers that can predict who is at high risk of developing TB. This research could lead to new treatments that focus on strengthening the immune system’s ability to control the infection, rather than just killing the bacteria.

“My dream is to move away from this one-size-fits-all approach and towards an understanding that there are different types of TB patients who would benefit from different types of treatment,” says Suliman.

These advancements in treatment, diagnosis, and understanding the disease’s progression offer hope for a future where TB is no longer a global health threat.

Disclaimer: This news article is based on information provided by the University of California. It is intended for informational purposes only and should not be considered medical advice. Consult with a healthcare professional for any1 health concerns.

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