Tuberculosis and HIV co-infection—focus on the Asia-Pacific region

Abstract

Tuberculosis (TB) is the leading opportunistic disease and cause of death in patients with HIV infection. In 2013 there were 1.1 million new TB/HIV co-infected cases globally, accounting for 12% of incident TB cases and 360,000 deaths. The Asia-Pacific region, which contributes more than a half of all TB cases worldwide, traditionally reports low TB/HIV co-infection rates. However, routine testing of TB patients for HIV infection is not universally implemented and the estimated prevalence of HIV in new TB cases increased to 6.3% in 2013. Although HIV infection rates have not seen the rapid rise observed in Sub-Saharan Africa, indications are that rates are increasing among specific high-risk groups. This paper reviews the risks of TB exposure and progression to disease, including the risk of TB recurrence, in this vulnerable population. There is urgency to scale up interventions such as intensified TB case-finding, isoniazid preventive therapy, and TB infection control, as well as HIV testing and improved access to antiretroviral treatment. Increased awareness and concerted action is required to reduce TB/HIV co-infection rates in the Asia-Pacific region and to improve the outcomes of people living with HIV.

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

“…5,23 Tuberculosis (TB) is the leading opportunistic disease and cause of death in patients with HIV infection. 24,25 Given the high rates of TB-HIV co-infection, higher usage of antitubercular agents is justifiable.…”

“…6 Majority of studies from India and other countries have found tuberculosis to be the most common opportunistic infection among people with HIV infection. 24,25 Understanding HIV-TB co-infection is of great importance because of increasing prevalence of co-infection, severity of clinical presentation of TB in HIV-positive patients, rapid progression of HIV disease in TB patients and challenges in treatment of co-infected patients due to drug interactions and immune reconstitution syndrome.…”

Análise Epidemiológica Da Coinfecção Tuberculose/Hiv

“…No Brasil, a realização de testes rápidos do HIV para esses pacientes apresentou um bom desempenho em região do Centro-Oeste, entretanto conjectura-se que existam disparidades de desempenho entre as diferentes regiões do Brasil (4)(5) .…”

“…Países com alta epidemia como na África ainda subestimam a real magnitude dessa infecção. As principais barreiras que interferem nessa implementação são a ausência de orientação, baixa adesão por parte dos trabalhadores de saúde, a falta de kits do HIV e a supervisão inadequada por ambos os programas de TB e HIV (4,(6)(7) . Diante disso, este estudo objetiva caracterizar o perfil epidemiológico da coinfecção TB/HIV, com o intuito de promover a discussão sobre assistência pelos serviços de saúde e proporcionar subsídios para implementar medidas de prevenção dessa coinfecção.…”

TB Presenting as Recurrent Pneumonia in a HIV-Infected Infant in Central Viet Nam

“…Although there is increased awareness that children in HIV-affected households are at high risk of developing TB [2], this is often not the case in Asian countries like Viet Nam, where TB/HIV co-infection is less common than in sub-Saharan Africa [3]. In many Asian countries, the uptake of HIV testing in pregnancy remains low, because this is not routinely offered by health care workers as part of standard antenatal care [4] and because mothers are often unaware of its importance.…”