New York Times (02.17.2014)
The New York Times reported on a study treating patients with multidrug-resistant TB and HIV/AIDS coinfection. Previously, healthcare practitioners treated TB first and waited weeks before beginning HIV/AIDS treatment. In this study, healthcare providers treated both diseases simultaneously. The study of 23 South African patients with drug-resistant TB and AIDS showed successful results that agreed with those of three major studies of people with regular TB and AIDS.
According to Dr. Gerald Friedland, a TB specialist at Yale School of Public Health, the concept of treating TB and waiting to treat HIV is a throwback to the early days of HIV/AIDS, when specialists were familiar with TB treatment, but doctors knew little about this new disease. The belief was that weak TB patients would die from the inflammation and fluids released into the lungs as a result of “immune reconstitution” after antiretroviral treatment, but Friedland noted that this can be managed with anti-inflammatory drugs. Also, drugs used to treat HIV were more toxic than current antiretrovirals, and patients took many pills in addition to the TB pills. This made treatment of both diseases very complicated and resulted in patients’ non-adherence.
The full report, “Improved Survival in Multidrug-Resistant Tuberculosis Patients Receiving Integrated Tuberculosis and Antiretroviral Treatment in the SAPiT Trial,” was published in the International Journal of Tuberculosis and Lung Disease (2014; 18(2):147–154).