TORONTO, Aug 17, 2006 (AFP) - Co-infection by HIV and the tuberculosis germ is a fast-growing problem in the global AIDS epidemic, with the two pathogens working in tandem to end a quarter of a million lives every year, the 16th International AIDS Conference has heard.
"More than a third of all people infected with HIV are also infected with the tuberculosis bacillus," Helene Gayle, president of the International AIDS Society, which is organising the six-day event, said Wednesday.
"Joint TB and HIV interventions can save lives and must be accelerated."
Last year, there were at least four million new cases of HIV infection and nearly nine million new TB cases, said Paul Nunn of the Stop TB Partnership. Of the more than two million people who died of AIDS, more than one in 10 was killed by TB, a rate that rises to six in 10 in southern Africa.
The problem with co-infection is that many people carry the TB bacterium but do not know it -- only one in 10 infected by the germ actually develop the disease.
But the bug can reactivate years, even decades, later if the immune system is weak, which is what happens when an individual is infected with the human immunodeficiency virus (HIV). In some cases, co-infection of this kind can lead to death within months, experts said.
They called for efforts to step up testing of TB and for the introduction of new diagnostic tools that can swiftly spot the presence of the bacillus, and for drug companies to invest more in tackling the worsening problem of tuberculosis strains that resist frontline antibiotics.
"TB prevention, diagnostic and treatment services must become core functions of all HIV services," said Kevin De Cock, head of the HIV/AIDS department at World Health Organisation (WHO).
"People living with HIV are more vulnerable to TB, even if they're on antiretroviral therapy.
"TB can be treated and cured, so most of these deaths are absolutely preventable."
A US-led organisation released the first findings of a study in Brazil that spelt out ways of preventing TB in those with HIV.
It is called CREATE -- the Consortium to Respond Effectively to the AIDS-TB Epidemic -- with the lead role taken by the Johns Hopkins Center for Tuberculosis Research in the US, backed by researchers and health-policy experts from Africa, South America and Europe.
"TB preventive treatment is successful in reducing TB cases in people living with HIV and AIDS, even for those who are already taking life-saving antiretroviral drugs," the study's principal investigator, Richard Chaisson, said.
Former South African president Nelson Mandela cast the spotlight on the TB/HIV link at the 15th International AIDS Conference in Bangkok in 2004.
Since then, there have been pledges on this issue at this year's UN General Assembly Special Session on AIDS and G8 summit, and also at last year's African summit in Nigeria, which called on all African leaders to intensify action on TB.
Developing countries already have a well-known strategy for combating TB.
DOTS -- directly observed therapy short course -- requires careworkers to monitor carefully that the patient takes a short course of powerful antibiotics all the way through to the end, ensuring that all the TB germs are wiped out rather than linger in a reservoir.
But DOTS relies on patients seeking treatment themselves and targets only those with active TB, not with latent infection.
This means more needs to be done to tackle non-symptomatic cases.
One approach is to encourage testing in places where TB is known to flourish, such as prisons or migrant workers' hostels in southern Africa, but for this to be truly effective, health workers need new-generation diagnostic tools and smarter drugs to combat the mutating germ.
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