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TB and HIV Coinfection 2005
DTBE publications can be ordered using the online order system. What can HIV/AIDS Service Organizations Do to Help?
HIV-Related TB Can Be Prevented and Cured – and You Can Help! Many people think tuberculosis (TB) is a disease of the past. However, in spite of fewer people in this country suffering with TB, it remains a serious threat, especially for HIV-infected persons. In fact, worldwide TB is responsible for the deaths of one in three people living with HIV/AIDS – making it the leading cause of death among people infected with HIV. As someone working in an AIDS service organization (ASO), you can play a critical role in ensuring that HIV-related TB can be prevented and cured in your clients. What is TB?TB is a disease caused by bacteria called Mycobacterium tuberculosis. This disease primarily affects the lungs, but can attack any organ in the body. TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected. However, not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease. Both of these conditions are treatable and curable. What is the difference between latent TB infection and active TB disease?In most people who breathe in TB bacteria and become infected,
the body is able to fight the bacteria and stop them from growing.
The bacteria become inactive, but they remain alive in the body
and can become active later. This is called latent TB infection.
There are an estimated 9 to 14 million persons in the However, in some cases TB bacteria can become active if the immune system can’t stop them from growing. These bacteria begin to multiply in the body and cause active TB disease. Because HIV weakens the immune system, people with latent TB infection and HIV infection are at very high risk of developing active TB disease. People with latent TB infection
People with active TB disease
What is a TB skin test?The TB skin test is a method used to diagnose TB infection. A small needle is used to inject some testing material, called tuberculin, into the upper layers of the skin. This is usually done on the inside of the forearm. The person getting the test must return two to three days later to have the test site on the arm examined by a nurse or doctor. If there is a reaction on the arm, the size of the reaction is measured. A positive reaction, usually a small bump, means that the person probably has TB infection. Other tests are needed to determine if the person has latent TB infection or active TB disease. All HIV-infected people should be given a TB skin test to find out if they have TB infection. Some people who are infected with both HIV and TB will not react to the TB skin test. This is because the immune system is not working properly. Anyone who is HIV infected and has a negative TB skin test should also be given other medical tests such as a chest x-ray if they have symptoms of active TB disease. To find out where TB skin tests are offered in your community or to determine if your organization should provide skin testing services, contact your state or local health department’s TB control program. Why should I be concerned about TB and HIV coinfection?
Good NewsThe good news is that HIV-infected persons with either latent TB infection or active TB disease can be effectively treated. The first step is to ensure that HIV-infected persons get a TB skin test and any other needed tests. The second step is to help the people found to have either latent TB infection or active TB disease get proper treatment. Rapid progression from latent TB infection to active TB disease can easily be prevented. Active TB disease can be treated and cured in HIV-infected persons. TreatmentThere are a number of treatment options for HIV-infected persons with either latent TB infection or active TB disease. For the latest guidelines about the different treatment regimens, refer to the resources listed on the back of this brochure, and also consult with your state or local health department. It is important for HIV-infected patients to be closely monitored by a physician during any type of treatment to make sure they are not hurt by side effects from taking TB and HIV medicines together. Monitoring is also important to make sure the TB medicines are not interacting with patients’ HIV medicines in a way that could weaken the strength of the HIV medicines. The medicine usually used to treat latent TB infection:
Taken as prescribed, INH will kill the TB bacteria in the body and prevent the development of active TB disease. Multiple medicines are used at the same time to treat active TB disease:
To treat active TB disease, several different medicines are needed. This is because there are many bacteria to be killed. Taking several drugs will do a better job of killing all of the bacteria and preventing them from becoming resistant to the drugs. A crucial component of treating active TB disease is directly observed therapy (DOT). With DOT, a health worker watches the patient swallow each dose of TB medication. DOT increases patient adherence and prevents relapses, continued transmission, and the development of drug resistance. If resources are available, DOT may also be beneficial for the treatment of latent TB infection, especially in HIV-infected persons. To find out if your organization can help with DOT services, please contact your state or local health department’s TB control program. How can your organization help prevent HIV-related TB in your clients?Collaborate with your state or local health department’s TB control program to:
Other ways your organization may be able to help:
CDC publications about TB for your health care providers:
CDC Publications about TB for your clients:
For more information, the following resources are also available:
Or contact your state or local health department
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Elimination
Centers for Disease Control & Prevention |