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The Deadly Intersection Between TB and HIV


Tuberculosis (TB) is a disease that is spread from
person-to-person through the air, and it is particularly dangerous
for people infected with HIV. Worldwide, TB is the leading cause of
death among people infected with HIV.

An estimated 10-15 million Americans are infected with TB bacteria,
with the potential to develop active TB disease in the future. About
10 percent of these infected individuals will develop TB at some
point in their lives. However, the risk of developing TB disease is
much greater for those infected with HIV and living with AIDS.
Because HIV infection so severely weakens the immune system,
people dually infected with HIV and TB have a 100 times greater
risk of developing active TB disease and becoming infectious
compared to people not infected with HIV. CDC estimates that 10 to
15 percent of all TB cases and nearly 30 percent of cases among
people ages 25 to 44 are occurring in HIV-infected individuals.

This high level of risk underscores the critical need for targeted TB
screening and preventive treatment programs for HIV-infected
people and those at greatest risk for HIV infection. All people
infected with HIV should be tested for TB, and, if infected, complete
preventive therapy as soon as possible to prevent TB disease.

Intersection of Two Global Epidemics
Approximately 2 billion people (one-third of the world's population)
are infected with Mycobacterium tuberculosis, the cause of TB.
TB is the cause of death for one out of every three people with
AIDS worldwide.
The spread of the HIV epidemic has significantly impacted the TB
epidemic - one-third of the increase in TB cases over the last five
years can be attributed to the HIV epidemic (Source: UNAIDS).
The Continued Threat of Multidrug-Resistant TB
Every nation must face the challenge of combating
multidrug-resistant (MDR) TB. People infected with HIV and living
with AIDS are at greater risk for developing MDR TB. MDR TB is
extremely difficult to treat and can be fatal. While the number of
cases has remained stable in the United States over the past few
years, people with MDR TB have now been reported from 43 states
and the District of Columbia.

To prevent the continued emergence of drug-resistant strains of
TB, treatment for TB must be improved in the United States and
across the globe. Inconsistent or partial treatment is the main cause
of TB that is resistant to available drugs (MDR-TB.) The most
effective strategy for ensuring completion of treatment is Directly
Observed Therapy, and its use must be expanded.

Another challenge that individuals co-infected with HIV and TB face
is the possible complications that can occur when taking HIV
treatment regimens along with drugs commonly used to treat TB.
Physicians prescribing these drugs must carefully consider all
potential interactions.

Addressing the Dangers of the Interconnected TB/HIV Epidemics
Requires Expanded Efforts
TB control is an exercise in vigilance; the goal of controlling and
eventually eliminating TB requires a targeted and continuous effort
to address the prevention and treatment needs for those most at
risk, including HIV-infected individuals. Efforts to eliminate TB are
therefore essential to reducing the global toll of HIV.



Source:
Divisions of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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