Health Watchdogs Sound Alarm Over TB/HIV Deaths

The scourge of co-infection with HIV and TB is the target of a health care initiative launched at the 18th International AIDS Conference in Vienna.

UNAIDS and the public-private Stop TB partnership joined forces in a campaign to cut the annual number of deaths from HIV/TB to 200,000 by 2015, half the number reported in 2004.

"Every three minutes a person living with HIV has his or her life cut off prematurely by TB," said Jorge Sampaio, UN Secretary-General Ban Ki-moon's special envoy on tuberculosis. "This is completely unacceptable. TB is a preventable and curable disease."

While acknowledging that reaching the goal would require billions of dollars annually, conference speakers focused on low-cost strategies that have been shown to cut HIV/TB mortality. "There is a package of activities that, if properly implemented by countries, will work," said Stop TB Executive Secretary Marcos Espinal.

Health care facilities and laboratories should be designed to handle both HIV and TB. To help identify and treat TB as early as possible, health care workers should ask HIV-positive patients whether they have had any recent coughing episodes.

In addition, French and U.S. researchers reported trial results that suggest changes in the typical treatment schedule for patients co-infected with HIV and TB.

In a Cambodian trial of seriously ill HIV patients newly infected with TB, researchers compared the standard approach, starting TB treatment and then waiting eight weeks to initiate antiretroviral therapy (ART), with an experimental approach of waiting only two weeks to introduce HIV treatment. The team recorded 59 deaths among the 332 patients who started ART at two weeks, compared to 90 deaths among the 329 patients who started ART at eight weeks (death rates of 18 percent and 27 percent, respectively).

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