"TB" the Number One Killer of People With HIV

TB is an infection caused by a bacterium called Mycobacteria tuberculosis. It usually affects the lungs but can affect other organs also. TB is a very serious disease, it is estimated that one-third of the people in the world are infected with TB. Ten to 15 million Americans are infected carriers of TB. Tuberculosis (TB) is spread from person to person through the air. If someone with active TB coughs or sneezes on anyone who is close, they can breathe in the bacteria from the air and possibly become infected.

There are two stages of tuberculosis. The first is "inactive TB infection": when a person has been infected with the TB germ, but their body was able to fight the germ and keep them from getting sick.

• People with inactive TB infection cannot spread the germ to others.

• They will however test positive to a TB skin test.
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• They can take medications to kill the inactive germs in their body so the germs can't become active in the future. If you don't treat the inactive TB germ it can become active making you very sick and infectious later.

Then there is "active TB disease": if a persons' immune system is weak or if they are a young child the TB germs can become active soon after infection. People with strong immune systems often won't get sick at all or not for many years. Symptoms of active TB disease are:

• Cough that lasts longer than two weeks.

• Cough that produces green or yellow sputum.

• A fever that last more than three days.

• Night sweats.

• Unexplained weight loss of eight pounds or more.

People with active TB must be isolated so they don't infect others. They need to take several medications but usually respond very quickly and feel better. They must take the medication for six months or more though; to make sure they don't relapse into sickness and become infectious again. They can also build resistance to the TB medications, if they don't take them correctly or for a long enough time.

The risk of developing active tuberculosis is much higher in people who are infected with HIV. Because HIV weakens the immune system, people that have both HIV and TB are 40 times more likely to develop active, infectious TB than people who are not HIV positive. One of the most important aspects of having HIV and TB is that they both make each other worse. TB makes HIV multiply faster and HIV helps TB become active. It is very important for people that are HIV positive to be tested for TB. If infected you need to complete preventive therapy as soon as possible to prevent the TB germ from causing the active disease of tuberculosis, causing your viral load to sky rocket, make you sick and possibly even kill you.

It is not easy to treat both TB and HIV at the same time. The drugs used to treat TB and HIV can both cause damage to the liver and kidneys. Also there can be negative drug interactions between the medications used to fight these two individual problems. It is not easy to handle the side effects of treating TB and it may take a long time but it can be cured. The treatment of TB in HIV positive people must be very carefully planned and monitored by a knowledgeable provider to insure that any problems that arise are picked-up and addressed quickly. Communication with your provider is important.