TB and HIV are co-endemic but TB is preventable and treatable

Overview

Tuberculosis is the leading cause of death in persons with HIV. Co-morbidity with tuberculosis and HIV is a common cause of mortality in sub-Saharan Africa.  The Word Health Organization (WHO) reported that a total of 8.7 million cases of tuberculosis occurred globally in 2011, with 24% in the African region. About 13% of TB cases worldwide were co-infected with HIV, and approximately 430,000 deaths in HIV-infected persons in 2011 were due to tuberculosis.

To reduce the burden of both diseases and to maximize program effectiveness and efficiency, WHO has stressed the importance of strong collaboration between tuberculosis and HIV programs and integration of service delivery. Key interventions include:

• HIV testing and counseling in tuberculosis clinics
• Offering HIV prevention services to tuberculosis patients
• Tuberculosis screening and infection control in HIV clinics Provision of cotrimoxazole (Antibiotics that are used to treat or prevent certain types of infections caused by bacteria) to HIV-infected tuberculosis patients
• Providing ART to patients with HIV-associated tuberculosis early after diagnosis
• Offering preventive therapy for tuberculosis after exclusion of active disease to all persons living with HIV

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Co-epidemic

HIV and tuberculosis are so closely connected that their relationship is often described as a co-epidemic. In the last 15 years the number of new Tuberculosis cases has more than doubled in countries where the number of HIV infections is also high.

File picture: UN Special Envoy in the fight against tuberculosis Jorge Sampaio (L) chats with a patient during his visit at the Machava Hospital, outskirts of the Mozambician capital Maputo, Tuesday 03 April 2007. Photo: ANP/ EPA/Pedro Sa Da Bandeira

TB and HIV statistics:

• The two diseases are a deadly combination; they are far more destructive together than either disease alone
• In developing countries many people infected with HIV contract Tuberculosis as the first sign of AIDS
• At least one-third of the 38.6 million HIV-positive people in the world are also infected with Tuberculosis and are at greatly increased risk of developing Tuberculosis disease (the active and contagious form of TB)
• Tuberculosis is the leading cause of illness and death among people living with HIV in Africa and a major cause of death in HIV-positive people living elsewhere. In some settings, Tuberculosis kills up to half of all AIDS patients

Facts and Misconceptions

Myth: Only people with HIV get Tuberculosis

People often associate Tuberculosis with HIV. While it’s true that you’re more at risk of getting TB if you have HIV (HIV weakens your immune system and makes you more vulnerable to opportunistic infections, like TB), it doesn’t mean that all people with TB have HIV. TB can affect anyone.

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Fact: Poverty makes successful treatment difficult

Poverty and poor access to services challenges the successful treatment of those affected by TB and HIV. In some rural areas, the distances between home and clinics make it difficult for screening and drug collection. Many people find it hard to take drugs on a daily basis without sufficient food to go with them.

Fact: When someone has both HIV and TB each disease speeds up the progress of the other. In addition to HIV infection speeding up the progression from latent to active TB, TB bacteria also accelerate the progress of HIV infection.