El frente de la tuberculosis

BERLÍN – Éste ha sido un buen decenio en la lucha contra la tuberculosis. Es probable que logremos el objetivo de desarrollo del Milenio de las Naciones Unidas de reducir a la mitad en 2015 la prevalencia de la tuberculosis y la mortalidad causada por ésta, a partir de los niveles de 1990. Al menos una docena de vacunas nuevas y medicamentos aún no aprobados están sometidos a ensayos clínicos y la Organización Mundial de la Salud ha aprobado una nueva prueba de diagnóstico denominada GeneXpert.

Ese avance es tanto más importante cuanto que la complacencia provocó una completa paralización de la investigación e innovación en materia de nuevas intervenciones antituberculosas hacia el final del siglo XX. Los medicamentes antituberculosos que se utilizan actualmente se obtuvieron entre 1950 y 1970. De hecho, la vacuna Bacille Calmette-Guérin (BCG) tiene casi cien años de edad, mientras que la prueba de diagnóstico más utilizada, la detección en el microscopio de los bacilos en los esputos, se obtuvo hace 130 años.

No es de extrañar que la eficacia de esos instrumentos se haya debilitado. La vacuna actual previene la tuberculosis grave en lactantes, pero no la tuberculosis pulmonar más prevalente en todos los grupos de edad. Las pruebas de microscopio dan resultados falsos en casi la mitad de los casos.

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