Management of co-infection with HIV and TB

BMJ 2002;324:802-803

Improving tuberculosis control programmes and access to highly active antiretroviral treatment is crucial.

About a third of the 36 million people living with HIV worldwide are co-infected with mycobacterium tuberculosis; 70% of those co-infected live in sub-Saharan Africa. In developing countries half of people with HIV infection will develop active tuberculosis; in some countries in sub-Saharan Africa more than 70% of patients with active tuberculosis are also HIV seropositive.

Tuberculosis is the leading cause of death among people with HIV infection, accounting for a third of deaths due to AIDS world wide. The introduction of highly active antiretroviral therapy has decreased death and opportunistic infections by 60% to 90% among people living with HIV in affluent countries.

But in developing countries highly active antiretroviral therapy is available to a tiny minority of those who need it. Today there is a shocking inequality worldwide in the prognosis of HIV and tuberculosis co-infection, and it depends on whether patients or their country have access to highly active antiretroviral therapy.

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