Download HIV Associated TB: A Major Public Health Challenge Mitzi Nisbet

HIV Associated TB: A Major Public Health Challenge
Mitzi Nisbet, Infectious Diseases & Respitory Physician, Auckland DHB, Auckland, New Zealand
Co-infection with tuberculosis (TB) and human immunodeficiency virus (HIV) poses a tremendous
challenge to TB control, especially in resource-limited settings. Among the estimated 8.7 million new
TB cases in 2011, 1.1 million (13%) had HIV infection.
Co-infection with HIV leads to challenges in both the diagnosis and treatment of TB. Drug resistant
TB, including multi-drug and extensively drug resistant TB, are difficult to treat and also contribute to
increased mortality in patients with HIV infection. Sputum smear microscopy performs poorly in
patients with HIV-infection resulting in diagnostic delays. The treatment of co-infected patients
requires antituberculosis and antiretroviral drugs to be administered concomitantly but this may be
challenging due to a high pill burden, drug interactions, overlapping toxic effects and immune
reconstitution inflammatory syndrome.
An overview of the challenges and current recommendations for the diagnosis and treatment of
patients with TB and HIV dual infection will be discussed.