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UN: Many Lives Saved By Integrating HIV And TB Treatment

Lisa Schlein

The World Health Organization (WHO) reports that patients who receive integrated treatment for tuberculosis and HIV-AIDS have a far greater chance of surviving these diseases.  A six-year study finds more than 900,000 lives were saved globally by following TB/HIV integrated treatment programs.  

The six-year study has proven to be so successful that WHO is urging governments and health facilities to follow joint prevention, diagnosis and treatment programs for TB and HIV.

The WHO's director of the Stop TB Department, Dr. Mario Raviglione, explains HIV and tuberculosis are refereed to as dual epidemics because they are so closely linked.  

“HIV affects the immune system and increases, therefore, the likelihood of people acquiring TB infection and then developing TB disease.… TB is one of the leading causes of death in HIV-infected people.  We estimate around 350,000 people dying of HIV-related TB per year… and TB, therefore, is considered responsible for one out of four AIDS-related deaths,"   Raviglione said.

Raviglione says it makes sense to coordinate the treatment and prevention programs for HIV and TB.  And, that is what happened between 2004 and 2010.

In 2004, WHO published a new guide urging closer collaboration between TB and HIV-treatment activities.  Many governments began implementing this policy in 2005 with astonishing results.

WHO says the number of people living with HIV who were screened for TB increased almost 12-fold, from nearly 200,000 in 2005 to over 2.3 million people in 2010.  Testing for HIV among TB patients surged from 470,000 to over 2.2 million, a five-fold increase during that same period.

Dr. Raviglione says the most striking progress has been made in Africa.

“The number of countries…testing for HIV rose from five countries only in 2005 to 31 in 2010, including all of the highest burden countries when it comes to the TB-HIV co-epidemic.  Also…more than 60 percent of the estimated people living with HIV who developed active tuberculosis were identified and treated for tuberculosis in 2010.  So, these are quite remarkable public health and clinical results,” Raviglione said.  

As a consequence, Dr. Raviglione says nearly one million lives were saved.  He says these people would have died without the application and implementation of these interventions.

There are three main elements in WHO’s updated guidance policy.  The U.N. health agency says TB patients, their partners or family members should be routinely tested for HIV.  

It says all TB patients who are infected with HIV should be given cost-effective medicine to prevent against lung or other infections.  And it recommends all TB patients with HIV start on anti-retroviral therapy within the first two weeks in which they start anti-TB treatment.  

WHO stresses these services should be provided in an integrated manner at the same time and place.

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