Recurrent tuberculosis (TB) following successful treatment constitutes a significant challenge to TB control strategies. TB recurrence can be due to either reactivation of the same strain, i.e., relapse, or reinfection with a new strain. Recurrence due to reinfection has become an area of intense study due to its perceived significance in TB endemic settings with high rates of human immunodeficiency virus (HIV) coinfection. This review presents a descriptive analysis of recurrent TB disease and explores risk factors, immunopathogenesis, treatment, and preventative strategies. Currently available laboratory methods used to discriminate tuberculosis recurrence due to reinfection and relapse are discussed. We highlight risk factors for recurrence and strategies for early detection of TB recurrence. Enhanced treatment options such as intensified initial treatment, extension of treatment, and secondary preventative therapy for patients presenting with multiple risk factors are explored in this review. The potential value of identifying immunological correlates of risk and protection in recurrent TB is also briefly examined.
Part of the book: Tuberculosis