TBnet Forum

Today is #WorldAIDSDay2020. Unlike #tuberculosis, HIV cannot be cured and yet the leading cause of death among people with HIV is TB. Early diagnosis and effective treatment means survival with both conditions. That is why we must demand access to healthcare for everyone. #COVID19 has disrupted healthcare globally. After years of declining incidence, @WHO now predicts a rise in deaths from HIV & TB. We must refocus our attention & resource on these global killers. TB is curable. HIV is treatable. #WorldAIDSDay2020 #UequalsU

The World Health Organization recommends systematic screening for TB symptoms in people living with HIV as an essential component of the HIV care package, together with linkage to diagnostic services, as necessary. TB diagnosis in HIV-infected patients may be challenging due to higher rates of extrapulmonary disease and sputum smear-negative pulmonary TB. Smear-negative, culture-positive pulmonary TB frequently occurs with advanced immunosuppression. Many active TB cases can therefore remain undiagnosed in people living with HIV.

TB is the leading cause of death among people with HIV, accounting for some 208000 people who died from HIV-associated TB in 2019 and about a third of AIDS deaths Integrated therapy is crucial for HIV-infected patients with TB. Many challenges are faced with concurrent treatment of tuberculosis and HIV - adherence, side effects, drug drug interactions, risk of immune reconstitution inflammatory syndrome. Moreover, investments are needed in the RR-TB/HIV agenda to make available everywhere both ARV and TB second-line drugs, to reduce stigma learning from decades of HIV fights, to implement shorter all-oral effective and safe RR-TB treatment.