Overlapping Epidemics: TB, HIV and Viral Hepatitis
Disturbing reports of overlapping TB, HIV, and viral hepatitis epidemics emerged at the 2005 International AIDS Society Conference. In the newly independent states of Eastern Europe and Central Asia, HIV incidence continues to rise, and viral hepatitis is highly prevalent among prisoners, injection drug users, the homeless, and people in tuberculosis treatment programs.
Globally, tuberculosis is the leading cause of death among HIV-positive people. Poverty, incarceration, homelessness, and poor nutrition increase the risk for TB in populations where HIV and viral hepatitis are already endemic. Although TB is curable, co-infection with HIV complicates the diagnosis of TB and the treatment of both TB and HIV. Interactions between TB medications and antiretroviral agents restrict HIV treatment options. Additionally, certain drugs used to treat HIV and TB can cause hepatotoxicity. Coinfection with viral hepatitis increases the risk for antiretroviral-induced hepatotoxicity, and may, in turn, increase the risk for hepatotoxicity from TB therapy.
Tuberculosis can be cured. HIV and viral hepatitis can be prevented. When prevention is not possible, thorough screening, healthcare, and treatment services must be made available. Strategies to reduce the incidence and mortality of HIV, TB, and viral hepatitis in these regions will fail unless they consider the complex prevention, care and treatment needs of drug users and other groups vulnerable to this triple threat.
References available online.
This article was provided by Treatment Action Group. It is a part of the publication TAGline.