TB Testing, Treatment Should Be Linked With HIV Prevention Programs, WHO Official Says
African countries, especially those in Southern Africa, must link tuberculosis testing and treatment with HIV prevention programs to more effectively fight HIV/AIDS, Kevin de Cock, head of the World Health Organization's HIV/AIDS department, said recently at the 3rd South African AIDS Conference in Durban, South Africa, Reuters reports. De Cock said that the continued use of traditional treatments for TB could fuel the spread of the disease and exacerbate the HIV/AIDS epidemic. "TB programs alone cannot reverse the tide" of HIV/AIDS, he said, adding that it is vital to offer those living with HIV/TB coinfection convenient and effective treatment for both diseases.
The emergence of extensively drug-resistant TB, which is resistant to the two most potent first-line treatments and some of the available second-line drugs, in South Africa's KwaZulu-Natal province, neighboring Lesotho and other parts of the world has created a more serious threat, especially in Southern Africa, where HIV/AIDS and TB are prevalent and interlinked. In South Africa, approximately 61% of the roughly 250,000 people diagnosed annually with TB have HIV, Reuters reports. XDR-TB also has led to higher mortality rates and faster deaths among HIV-positive people, according to Reuters. In addition, although people living with HIV/TB coinfection might have access to antiretroviral drugs, they often do not receive treatment simultaneously for both diseases.
Robin Wood, director of South Africa's Desmond Tutu HIV Center at the University of Cape Town, said, "HIV has caused a devastating reversal in our ability to treat TB." He added that the solution is to combine HIV and TB treatments, which will require a large investment in TB laboratories, as well as related medical infrastructure and resources, in much of Africa. Researchers are developing a urine-based dipstick test that would give TB results almost instantly. Wood said this "would be a great asset if we could get it" (Simao, Reuters, 6/7).