Joint action on HIV and TB saved 900,000 lives: WHO
The WHO’s updated strategy calls for routine HIV testing for all TB patients, people with symptoms of TB, and those close to them.
It also recommends the quick start of treatment for all those who test positive for the AIDS virus with both co-trimoxazole, a drug to protect against lung or other infections, and with AIDS drugs known as antiretroviral therapy (ART).
The Numbers - United States
- Approximately 1.1 million persons were living with HIV infection at the end of 2006. As many as 21% of infected persons are unaware of their infection.
- It is estimated that about 4.2% of Americans with or without HIV infection are infected with the TB bacteria. That means in 2009 there were approximately 13 million Americans with LTBI.
- In 2009, among persons with TB who had a documented HIV test result, more than 10% (690 of 6,743) were co-infected with HIV.
- In 2005, of the TB patients reported to be co-infected with HIV, 63% were non-Hispanic blacks.
- In 2006, the HIV status of 1 in 5 patients with TB was not known, even though CDC recommends that all persons with TB be tested for HIV.
- In 2006, nearly 20% of patients with TB and HIV died. Persons with HIV and TB accounted for 32% of those who died during TB treatment and 51% of those who received a TB diagnosis after death.
It said these services and treatments “should be provided in an integrated manner at the same time and place.”
Do TB-Type Bacteria Cause AIDS?
It must be clearly understood that one cannot catch HIV/AIDS by close contact with a patient, although HIV is obviously spread through unprotected sex with an infected person.
HIV is not spread in the air. However, the acid-fast mycobacteria that cause human pulmonary TB can spread from person-to-person via inhalation. Unlike other bacteria, mycobacteria are colored red or red-purple when stained with a laboratory acid-fast staining procedure . Thus, the “acid-fast” stain is used to identify mycobacteria and is a unique characteristic of these microbes.
The two common types of acid-fast mycobacteria found in AIDS are Mycobacterium tuberculosis (the germ that causes human TB) and Mycobacterium avium. M. tuberculosis is found only in humans, but other species or types of “non-tuberculous” mycobacteria (like M. avium) can be found throughout nature, in water, soil, animals and in man. Please consult the Wikipedia for more details about tuberculosis and the various species of acid-fast mycobacteria that can infect persons with AIDS.
HIV and TB mycobacteria are a lethal combination. Someone who is HIV-positive and infected with TB bacilli is many times more likely to become sick with TB than someone infected with TB bacilli who is HIV-negative. Most frightening is the fact that more and more cases of drug-resistant TB are appearing in HIV-infected patients, particularly in sub-Saharan Africa.
The World Health Organization estimates that every second someone in the world is newly infected with TB bacteria. One-third of the world’s population is infected with TB microbes. Most infected people will not develop pulmonary TB because the immune system “walls off” the TB bacilli and allows them to lie dormant for years. However, when someone’s immune system is weakened, the chances of becoming sick with TB are greater.
TB mycobacteria are known to be “pleomorphic,” in that they can exhibit various growth forms in culture and in tissue. “Pleomorphic” forms of M. tuberculosis and other species of “non-tuberculous” and “atypical mycobacteria” have been studied for decades for their effects on human illness. Unfortunately, scientists rarely pay attention to these pleomorphic forms; and pathologists rely primarily on the demonstration of the “typical” acid-fast rod forms of mycobacteria to diagnose tuberculosis and/or mycobacterial disease. This is unfortunate because the acid-fast bacteria that are demonstrable in AIDS and cancer (and certain other immunological diseases) are primarily pleomorphic and “filterable” forms, which often go unrecognized.
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By Alan Cantwell, MD
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(Reuters)