Treating TB AND AIDS

Reuters has a report on a new study that suggests that treating AIDS and tuberculosis simultaneously could save more than twice as many lives as going after tuberculosis first would:

About 33 million people worldwide are infected with HIV, the AIDS virus, and 9.2 million have recently been diagnosed with lung-destroying tuberculosis, according to the World Health Organization.

In many cases, HIV’s suppression of the immune system allows the deadly tuberculosis bacterium to thrive. In South Africa, about 73 percent of TB patients also have HIV.

Yet doctors have been reluctant to treat both at once, often choosing to go after TB first. They have been concerned about drug interactions, overlapping side effects and the large number of pills that patients have to take each day.

“You add to the risk of side effects very substantially,” Dr. Salim Abdool Karim of the University of KwaZulu-Natal, in Durban, South Africa, said in a telephone interview.

Treating TB requires months of antibiotics. HIV is incurable and patients must take cocktails of antiviral drugs for life.

“What you don’t want is patients stopping the TB drugs,” Karim said. “So most doctors treating a patient with TB and HIV prefer to finish with the TB drugs and then start on the antiretroviral drugs.”

They tested more than 600 patients with both TB and HIV.

The death rate was 5.4 percent a year for the volunteers who got treatment for both infections, compared with 12.1 percent for those whose TB was treated first, with HIV therapy beginning about six months later.

The results were so convincing that they already prompted the WHO to change its guidelines to call for treating both conditions at the same time.

You can read more details here.