HIV patients vulnerable to TB

Chhatra Karki, Nepal
(First published in Kapan, Nepal)
Tuberculosis (TB) and HIV co-infection is now emerging as a big threat in the health sector around the world. As people living with HIV (PLHIV) gradually lose their immune power, they become more vulnerable to the infection of TB. As per a report, there are 34 million PLHIV around the world; and 11 million of them have been affected by severe forms of TB.

According to the National Tuberculosis Centre in Kathmandu, Nepal, there are 50,000 PLHIV in Nepal and 2.4% of them (around 1200) are co-infected with TB too.

Experts say that PLHIV should avoid infection with TB. As compared to normal people, chances of PLHIV  contracting TB are 21-24 per cent higher. Therefore, they  should regularly visit hospitals for health checkups. They should also be careful about their diet. Dr Paula Fujiwara, Scientific Director, International Union Against Tuberculosis and Lung Disease (The Union) says, “People with HIV need to be screened for TB.  If they have active TB, they should be treated of course. But even if they are not, they must take precautions to be safe from it.”

TB can infect any one of us. If PLHIV have a confirmed diagnosis of active TB disease, treatment is possible. Experts advise them to start treatment of TB as soon as possible. It is imperative to save HIV positive people from TB. According to Dr Fujiwara, infection control is important.  Clinics, hospitals and and even our homes should be well vantilated. People should always cover their mouths and noses when they cough or sneeze. PLHIV and TB patients should not be kept in the same room for treatment.
Rajendra Panta, Director of National Tuberculosis Centre, Kathmandu, Nepal says, “If a PLHIV gets infected with TB, he/she should be treated as per DOTS (Directly Observed Treatment Shortcourse) - a World Health Organization (WHO) recommended standard anti-TB treatment.”

In some cases, PLHIV do not have classical symptoms of pulmonary TB . They may have TB in other body parts, which makes the matter further complicated. WHO has recently published a set of directives about ways to protect HIV positive people from being infected with TB. The approach and policies vary in different countries. Dr Valérie Schwoebel of  the International Union Against Tuberculosis and Lung Disease (The Union) Says, “The key element is the coordination between the TB and the HIV/AIDS national programmes, both of which exist in most countries.”

In recent years, the WHO has focused on equal responses to HIV and TB as these are interrelated with each other. HIV test of TB patients, Anti Retroviral Therapy (ART) for people infected with both TB and HIV as well as Cotrimoxazole Prophylaxis Therapy (CPT) therapy for them need to be packaged. Those  PLHIV who have active TB disease should be put on ART regardless of their CD4 count, as per the latest WHO guidelines issued earlier in June 2013.

Chhatra Karki, Nepal
Citizen News Service - CNS
(First published in Kapan, Nepal)

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