AEGiS-15IAC: HIV-related tuberculosis: how well are we doing with current control efforts?

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV-related tuberculosis: how well are we doing with current control efforts?

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10298)

Maher D, Borgdorff MW, Boerma JT
World Health Organization, Geneva, Switzerland

BACKGROUND: HIV is fuelling the tuberculosis (TB) epidemic and TB is a leading cause of illness and death among people living with HIV/AIDS (PLWHA). Interventions to control HIV-related TB comprise measures against both TB and HIV. How well are we doing in high HIV prevalence countries in implementing the interventions to control HIV-related TB, whether basic, e.g. the DOTS strategy and key HIV prevention measures, or more recent, e.g. intensified TB case-finding among PLWHA, TB preventive treatment and antiretroviral treatment (ART)?

METHODS: We used the most recent survey results published by international public health agencies as the main sources of data on TB and HIV programme activities, in order to review the status of implementation of selected key interventions to control HIV-related TB for the top 25 HIV prevalence countries.

RESULTS: Regarding implementation of the DOTS strategy for TB control, only 4 out of the top 25 HIV prevalence countries reported achievement of the target for treatment outcomes. Nearly all countries reported low levels of programme performance in implementing key HIV prevention measures. Many countries report little or no access to TB preventive therapy. In 2001 among 4.4 million people in sub-Saharan Africa with advanced stage HIV infection who could potentially benefit from ART, approximately 1% actually received ART.

CONCLUSIONS: TB and HIV programme performance in the top 25 HIV prevalence countries is generally low. Controlling HIV-related TB requires increased investment to fully implement the basic interventions (the DOTS strategy and key HIV prevention measures). In settings fully implementing these basic interventions, TB and HIV programme collaboration is necessary to scale up implementation of those additional interventions to control HIV-related TB (e.g. ART, intensified TB case-finding, and TB preventive therapy) which are of demonstrated feasibility, effectiveness and cost-effectiveness.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Tuberculosis, Africa South of the Sahara, HIV Infections, Prevalence, Disease Outbreaks, prevention & control, therapy

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