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TB, 'Achilles Heel' of HIV/AIDS Treatment


At the 16th International AIDS Conference, experts warned that tuberculosis may undermine much of the progress that’s been made with anti-retroviral drugs. They say urgent action is needed to prevent the deaths of 250,000 people living with HIV/AIDS every year. Anti-retroviral drugs now have a 10-year history of prolonging the lives of those living with HIV/AIDS. But while those drugs keep HIV at bay, patients may succumb rather quickly to TB infection. In fact, TB is being called the Achilles heal of HIV treatment. VOA English to Africa reporter Joe De Capua spoke with experts and people living with HIV/AIDS about treatments.

Anti-retroviral drugs now have a 10-year history of prolonging the lives of those living with HIV/AIDS. But while those drugs keep HIV at bay, patients may succumb rather quickly to TB infection. In fact, TB is being called the Achilles heal of HIV treatment.

Dr. Helene Gayle is conference co-chair and outgoing president of the International AIDS Society.

“While we must continue the urgent need to scale-up anti-retroviral therapy to people living with HIV/AIDS, access to tuberculosis drugs is one way in which we can have a huge impact in the lives of people living with HIV/AIDS today.”

The World Health Organization’s TB/HIV coordinator, Dr. Paul Nunn, says it’s time to act.

“In spite of knowing what to do and in spite of having policies to do it, we’re still not doing enough. Nelson Mandela’s call two years ago at Bangkok, if we want to fight AIDS we must do more to fight TB - is still insufficiently heeded. Countries are moving, but they’re not really moving fast enough.”

The WHO’s HIV Director, Dr. Kevin De Cock, says the effect of TB can be seen quite clearly in Africa.

“In sub-Saharan Africa, up to a third of deaths in patients with AIDS may be due to tuberculosis. And the very high incidence of tuberculosis even in patients on anti-retroviral drugs illustrates the huge importance of this association. What it means is that tuberculosis is a direct threat to the success of anti-retroviral drug scale-up.”

But there’s encouraging news about an old but very affordable drug, according to Dr. Richard Chaisson. He’s the principle investigator of a study indicating treatment with isoniazid can help prevent TB infection in people with HIV.

“Isoniazid Preventive Therapy for tuberculosis is a service that is badly needed throughout the developing world, but is little offered. Isoniazid is a drug that’s been around for over 50 years, is essentially free. It’s so inexpensive and has been known for decades to be highly effective in preventing tuberculosis in people at high risk.”

Lucy Chesire of Kenya joined the health experts to explain the problem in very personal terms.

“I’m a person living with HIV. And it’s really strange because for 10 years I was able to live with HIV very well and manage it in a very, very good way. And it’s only getting to know that I had TB that actually almost brought me to my death-bed.”

Chesire says it took a long time to recover.

“I had TB of the chest, TB adenitis, which is TB of the lymph nodes and at the same time TB of the knees. This resulted in me having to undergo three surgeries and spending seven good months on a hospital bed. That leads me to say that the reason I am speaking to you today is that we are saying that somebody can live with HIV for many years. The suffering I went through was because of TB.”

The WHO says TB is second only to HIV as an “infectious killer of adults,” some two million deaths every year.

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