TB-HIV co-infection: Antiretroviral therapy (ART) and anti-TB treatment save lives

Starting antiretroviral therapy (ART) in people co-infected with HIV and tuberculosis (TB) save lives. This reinforces already existing body of evidence of beneficial public health outcomes of providing ART along with standard anti-TB treatment to TB and HIV co-infected people. These new study results were presented at the recently concluded 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011). In 2010, Prof Anthony Harries, Senior Adviser, International Union Against Tuberculosis and Lung Disease (The Union) had said in an exclusive interview with CNS: "The most recent WHO advice issued in November 2009, is to give ART to ALL HIV infected TB patients regardless of CD4 count and to give it as soon as possible after the anti-TB treatment."

This new study, formally called Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPIT), explored when is the best time to begin ART during the anti-TB treatment in people co-infected with HIV and TB. It found that beginning ART in TB-HIV co-infected patients with a CD4 count of less than 50 cells/ mm3 reduced the death rate by 68 per cent.

At the 2010 XVIII International AIDS Conference held in Vienna, Austria, world's leading scientists had spoken to CNS and the message was clear: Putting TB-HIV co-infected people on the anti-retroviral therapy (ART) slows down HIV progression to AIDS.

The positive health outcomes of starting antiretroviral therapy (ART) in TB-HIV co-infected people are undisputed – regardless of their CD4 count – because it slows down HIV progression to AIDS.

In high burden countries, there is a need to test all TB patients for HIV (through provider initiated HIV testing) and of those HIV-positive who test positive for active TB disease, we must provide immediate cotrimoxazole preventive therapy, anti-TB therapy and ART as soon as possible.

Bobby Ramakant - CNS


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