Co-Epidemic Of HIV-TB Spreading In Africa, Undermining Global Control Of World's Two Deadliest Infectious Diseases

Main Category: HIV / AIDS
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 05 Nov 2007 - 4:00 PDT

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The largely unnoticed collision of the global epidemics of HIV and tuberculosis (TB) has exploded to create a deadly co-epidemic that is rapidly spreading in sub-Saharan Africa. However, health systems cannot adequately diagnose, treat, or contain the co-epidemic due to unanswered scientific and medical questions, according to a report issued by The Forum for Collaborative HIV Research and amplified by experts from leading global health organizations.

Approximately one-third of the world's 40 million people with HIV/AIDS are co-infected with TB, and the mortality rate for HIV-TB co-infection is five-fold higher than that for tuberculosis alone. This situation is made yet more urgent by the surging rates of multi-drug resistant TB in some areas with high HIV prevalence, according to the report.

"Now the eye of the storm is in sub-Saharan Africa, where half of new TB cases are HIV co-infected, and where drug-resistant TB is silently spreading," said Veronica Miller, coauthor of the report and director of The Forum for Collaborative HIV Research, a global independent public-private partnership comprised of researchers, patient advocates, and government and industry representatives. "Unlike bird flu, the global threat of HIV/TB is not hypothetical. It is here now. But the science and coordination needed to stop it are utterly insufficient."

First detected 23 years ago, HIV-TB now affects nearly one-third of the 40 million people infected with HIV. Without proper treatment, 90 percent of people living with HIV die within months of contracting TB.

The new report, titled "HIV-TB Co-Infection: Meeting the Challenge," is based on a symposium and roundtable discussion held in Sydney, Australia, during the International Aids Society (IAS) conference in July 2007. Along with the Forum for Collaborative HIV Research, many of the world's leading global health organizations co-sponsored these events, including the Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS) in France, the Bill & Melinda Gates Foundation, CREATE (Consortium to Respond Effectively to the AIDS-TB Epidemic), the European and Developing Countries Clinical Trials Partnership (EDCTP), the International AIDS Society, Tibotec, the U.S. National Institutes of Health, and the World Health Organization's (WHO) TB/HIV Working Group of the Stop TB Partnership.

Key findings include a six-fold increase in the caseload of drug-susceptible TB patients and a five-fold increase in multi-drug resistant and extensively multi-drug resistant TB (MDR- and XDR-TB) in some parts of southern Africa, all commonly associated with HIV-TB co-infection.

The Forum for Collaborative HIV Research is an independent public-private partnership whose mission is to facilitate discussion on emerging issues in HIV clinical research and the transfer of research results into care. It is comprised of international experts from government agencies, pharmaceutical companies, academia, advocacy and community organizations, and private foundations. The Forum is housed in the Department of Prevention and Community Health at The George Washington University School of Public Health and Health Services.

http://www.hivforum.org