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
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…..