Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
|
|
Wall Street Journal - Tuesday, July 9, 2002
Gautam Naik, Staff Reporter
So far, governments and other organizations have seen tuberculosis and HIV as two separate problems, and tackled them as such. But AIDS and TB form a deadly combination. While the TB bacterium lies dormant in about one-third of the world's population, the weakened immune system caused by AIDS can bring the disease to its full-blown form.
To address that, representatives of the WHO and the Bill and Melinda Gates Foundation will launch a unified strategy against the diseases at a news conference Tuesday at the International AIDS Conference in Barcelona.
The new plan includes an expanded effort to provide HIV-infected people with voluntary testing, counseling and preventive measures against TB, and vice versa. The plan also calls for greater collaboration between existing TB and HIV programs in various countries. And it seeks additional funds to fight the two diseases.
"It's an overlapping epidemic, so we're trying to bring the two together," says Dermot Maher, medical officer at WHO's Stop TB Department. Pilot projects for TB/HIV have already been started in South Africa, Malawi and Zambia, and will be soon introduced in Ethiopia, Kenya, Mozambique, Tanzania and Uganda.
TB is a contagious disease that spreads from person to person via the air. It causes fever, internal bleeding, weight loss and often death. Health experts agree that while a renewed onslaught against tuberculosis won't necessarily stem the AIDS epidemic, it will potentially reduce the deadly effect of TB in HIV suffers.
An HIV-positive person is 30 times more likely to develop active TB than someone who is HIV-negative. Such a person will see an acceleration of the onset of tuberculosis and -- if untreated for TB -- will typically die within weeks or months. By comparison, a similar person given TB drugs will live an additional two years.
TB may also have an effect on HIV. According to the U.S. Centers for Disease Control and Prevention, some studies suggest that an HIV-infected person's immune response to TB boosts the replication of the AIDS virus and might accelerate the natural progression of HIV.
As HIV and tuberculosis rates soar around the world, the number of co-infections is also increasing. Of the 8.2 million new TB cases in 2000, about 9% were attributed to HIV, according to estimates by the WHO. Of the 1.8 million deaths from tuberculosis, 12% were linked to HIV. On a global basis, TB now kills one of every three people infected with the AIDS virus.
This problem is especially acute in Africa, where, because of a widespread HIV problem, the number of TB cases is rising 6% each year, about three times the global rate. That suggests that the number of TB cases in sub-Saharan Africa will double to four million new cases a year soon after 2005, according to the Global Alliance for TB Drug Development, a nonprofit group.
TB experts hope that the twin HIV-TB crisis will also spur research into tuberculosis drugs. There hasn't been a new TB drug in about 30 years, mainly because researchers and pharmaceutical companies believed that the disease was on its way to being defeated. But now TB has come roaring back.
Says Mr. Maher of the WHO: "We still have a long, long way to go."
Write to Gautam Naik at gautam.naik@wsj.com
020709
WJ020707
Copyright © 2002 - The Wall Street Journal. Reproduction of this article (other than one copy for personal reference) must be cleared through the WSJ Permissions Desk.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Elton John AIDS Foundation UK, the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.
Always watch for outdated information. This article first appeared in 2002. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2002. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .