Abstract
Tuberculosis (TB) and human immunodeficiency virus (HIV) co-epidemics form a huge burden of disease in the Southeast Asia region. Five out of eleven nations in this region are high TB/HIV burden countries: Myanmar, Thailand, India, Indonesia and Nepal. The trends of TB incidence in these countries have been rising in recent years, in contrast to a falling global trend. Experts in the field of TB control and health service providers have been perplexed by the association of TB and HIV infections which causes a mosaic clinical presentation, a unique course with poor treatment outcomes including death. We conducted a review of contemporary evidence relating to TB/HIV control with the aims of assisting integrated health system responses in Southeast Asia and demystifying current evidence to facilitate translating it into practice.
Highlights
Tuberculosis (TB), a centuries-old disease, causes more than a million deaths every year
A brief delay in starting antiretroviral therapy (ART) 4 to 8 weeks after the initiation of TB therapy in patients with CD4+ T cell counts more than 200 cells/mm3 did not convey any increase in the risk of a new AIDSdefining illness or death, with a reduced risk of immune reconstitution inflammatory syndrome (IRIS) [29]
A randomized control trial of human immunodeficiency virus (HIV)-associated TB meningitis in Vietnam reported a very high mortality rate (59.8% and 55.6 %) regardless of whether ART started within seven days or after two months following the start of TB treatment
Summary
Tuberculosis (TB), a centuries-old disease, causes more than a million deaths every year. The WHO-recommended TB diagnosis models were compared in HIV-infected TB suspects, in terms of cost effectiveness, to reduce the mortality within 6 months of antiretroviral therapy (ART) initiation [18].
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