TB/HIV co-infection
On June 9, for the first time, governments, public health and business leaders, heads of UN agencies and advocates are coming together at United Nations (UN) Headquarters to acknowledge addressing HIV/TB as an urgent priority . This first HIV/TB Global Leaders' Forum, convened by Dr. Jorge Sampaio, the UN Secretary-General's special envoy to stop TB, seeks to galvanise leadership at all levels.
The 2008 "Anti-Tuberculosis Drug Resistance in the World" report and the 2008 "Global Tuberculosis Epidemic report of World Health Organization (WHO)" clearly mandates much heightened urgency in responding to TB-HIV co-infection.
Bangladesh continues to have the 5th highest TB burden in the world. TB is the leading cause of death among people living with HIV (PLHIV). Approximately one-third of the nearly 40 million PLHIV are also infected with TB. In high TB and HIV burden settings, up to 80% of TB patients may be co-infected with HIV, and half of AIDS-related deaths are caused by TB.
Without proper treatment with anti-TB drugs, approximately 90% of people living with HIV die within two to three months of becoming sick with TB, even if they receive anti-retroviral treatment.
Worldwide, nearly a quarter of a million people die from HIV/TB co-infection each year. This dual threat is a barrier to keeping people healthy and productive, and impacts poverty reduction plans and the broader development agenda. However, adequate treatment of TB in PLHIV can prolong their life by at least two years.
HIV weakens the immune system and makes it more likely that latent TB infection will progress to active TB disease. PLHIV are up to 50 times more likely to develop TB over their lifetime.
In many countries insufficient laboratory capacity to test drug-resistance is a serious impediment in scaling up TB programmes. Developing laboratories to provide rapid diagnosis of anti-TB drug-resistance, particularly for PLHIV, is of utmost importance to improve TB responses.
Many countries, including Bangladesh, are making impressive gains in treating people living with HIV, but this investment and progress is squandered by a preventable and curable disease -- TB.
New strategies and tools are urgently needed to tackle the challenge of TB/HIV co-infection. WHO-recommended collaborative TB/HIV activities must be accelerated, and research stepped up to deliver a new generation of effective anti-TB drugs and diagnostics to keep co-infected people alive. Closer coordination between national TB and HIV programmes and services is vital.
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