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HIV epidemic has posed major challenges to TB control
efforts globally. HIV weakens the immune system. Someone who is HIV-positive and infected
with TB is 5-7 times more likely to develop active TB than someone infected
with TB but not infected with HIV. TB
is a leading cause of death among people who are HIV-positive accounting for
about 11% of AIDS deaths worldwide.
Countries in the South-East Asia Region are beginning to
witness increasing numbers of TB-HIV co-infected individuals. The “dual
strategy for a dual epidemic” approach needs to be replaced by a
comprehensive and coherent response through a health strategy that addresses
both TB and HIV. The extent of the
TB/HIV epidemic in the Region will depend on the future course of the HIV
epidemic, as well as on efforts to control TB. It will require full implementation of
DOTS. It includes preventing HIV
infection, preventing progression of latent TB infection to active disease
and the provision of HIV/AIDS care and antiretroviral treatment on a
long-term basis. Tuberculosis is the
most common opportunistic disease in Asia among people living with
HIV/AIDS. While the double stigma of
HIV and TB leads to delays in TB diagnosis and treatment, mortality in HIV+
TB patients is also higher due to a worse prognosis or other opportunistic
infections occurring. With scaling-up
antiretroviral therapy in South-East Asia, management of TB/HIV will need
special attention in both programmes.
 Some facts about TB/HIV
 TB is an opportunistic disease that preys on
weakened immune systems; if not diagnosed early it can move very quickly in
HIV-positive individuals.
TB is the leading infectious killer of people
living with HIV/AIDS.
Up to 50% of people with HIV or AIDS develop
TB.
Worldwide, 14 million are co-infected with TB
and HIV. In the SEA Region
approximately three million are co-infected.
TB causes at least 11% of AIDS deaths and
possibly as many as 50%.
The lifetime risk of developing TB in an
HIV-positive individual is 50% as compared to the 5-10% risk of someone who
is HIV-negative
Most importantly, TB can successfully be
treated even if someone is HIV-infected.
Treatment of TB can prolong and improve the
quality of life for HIV-positive people but cannot alone prevent people from
dying of AIDS.
In the South East Asia Region five of the 11
countries are high- or moderate-TB/HIV burden countries: India,
Indonesia, Myanmar,
Nepal and Thailand.
Activities on TB/HIV in the South-East
Asia Region
That the incidence of both diseases is the highest in
the economically productive age groups, poses significant threats not only to
health; but also to social and economic development in the Region. WHO SEARO has taken the following
initiatives in response to this dual epidemic in the Region:
Regional Level
 Joint meetings of NTP and NAP managers 2001
and 2002
NTP managers briefed on 3 by 5 at NTP
Managers’ meeting 2003
Participation in the Global TB/HIV Working
Group
HIV/TB Regional framework developed and
disseminated
SEARO supported pilot projects at district
level; assessment of on-going interventions in countries; support for plans
to scale up
TB/HIV Conference for the Mekong Region
countries(2004)
Regional training course on TB-HIV planned
January 2005
Country level
Thailand:
 Structural integration; nation-wide HIV-TB
interventions, including INH preventive therapy at 22 sites
India,
Indonesia,
Myanmar
and Nepal:
Central level working groups/task forces on
HIV-TB; national policy formulated
HIV-TB surveillance at selected sentinel
sites; (India,
Indonesia, Myanmar)
Guidelines and training materials developed;
TB-HIV interventions initiated at selected sites (India,
Myanmar);
GFATM support sought for scaling up
Trainings
WHO is organizing, in collaboration with the Ministry of
Public Health, Thailand; the US Centres for Disease
Control and Prevention (CDC), Atlanta; and the Research Institute for
Tuberculosis (RIT), Tokyo, the first training course on TB/HIV for national
and peripheral level TB and AIDS programme
personnel from five countries (India, Indonesia, Myanmar, Nepal and Thailand)
in the South East Asia Region. This training course is scheduled to take
place from 17-28 January 2005 in Bangkok, Thailand, with field visits to pilot
TB/HIV projects in Ubon Ratchatanee
and Chiang Rai.
Publications (The PDF version of
publications is available under ‘Browse all Publication’ link available on
this page)
SEARO: Regional
Strategic Plan on HIV/TB (PDF Version)
List of
TB/HIV documents from WHO
Links
WHO
FAQs about TB/HIV:
http://www.who.int/tb/hiv/faq/en/
Stop TB Partnership coverage of XV International AIDS Conference: http://www.stoptb.org/events/internationalaidsconference/xv/
Information pack and advocacy materials on TB/HIV: http://www.stoptb.org/events/internationalaidsconference/xv/TBHIVInformationPack.asp
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