TB-HIV Presentation International Press Corp. E. Jane Carter, MD Associate Professor of Medicine Alpert School of Medicine at Brown University TB HIV Technical Consultant- AMPATH Partnership Eldoret, kenya. Outline of talk. Basic terminology and pathophysiology Epidemiology of TB and HIV
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E. Jane Carter, MD
Associate Professor of Medicine
Alpert School of Medicine at Brown University
TB HIV Technical Consultant- AMPATH Partnership
Autopsies show undiagnosed TB caused death in 14-54% of PLHIV
*Velasco et. al. JAIDS 2009;50:148-52.
**Manosuthi et. al. JAIDS 2006;43:42-6.
N Engl J Med 2010;362:697-706.
Reduction in mortality in combined treatment versus sequential therapy
So what does drug resistance imply for our HIV patients…..
Group 1 = per South Africa guidelines
Group 2 =consecutive patients on TB ward
Group 3 = consecutive TB suspects (9 months)
52 of 53 patients died
Median survival 16 days ( range 2-210)
B. To decrease the burden of TB in PLHIV- Three Is
B.1. Intensified TB case finding
B.2. Isoniazid preventive therapy
B.3. TB infection control in health care and other settings
A. Establish the mechanism for collaboration
A.1. TB/HIV coordinating bodies
A.2. HIV surveillance among TB patient
A.3. TB/HIV planning
A.4. TB/HIV monitoring and evaluation
C. To decrease the burden of HIV in TB patients
C.1. HIV testing and counselling
C.2. HIV preventive methods
C.3. Cotrimoxazole preventive therapy
C.4. HIV/AIDS care and support
C.5. Antiretroviral therapy to TB patients.
is the translation of scientific advancement into day to day practice
Maybe there will be answers,
maybe not yet…..