AEGiS-WSJ: TB Is Largest Killer Of Those With HIV Wall Street JournalImportant note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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TB Is Largest Killer Of Those With HIV

Wall Street Journal - July 18, 2002
Nina Schwalbe

In an otherwise excellent article on Russian prisons and HIV ("Infected Cells: As HIV Epidemic Hits Russia, Crux of Problem is Jail1," June 25), Mark Schoofs overlooks a significant problem: tuberculoses and multi-drug resistant tuberculoses (MDR-TB).

Often referred to as "Ebola with wings," TB is the largest single killer of people living with HIV. By weakening the immune system and increasing the risk of developing TB, HIV is the most potent force driving the TB epidemic. Similarly, TB can result in the more rapid progression of HIV infection to AIDS.

Russia has one of the highest TB and MDR-TB infection rates in the world. The Russian Federation also has the fastest growing rates of HIV infection, intravenous drug use, and, after the U.S., the world's second-highest incarceration rates.

Russia's prisons are the primary "pump" for its TB epidemic. More than 10% of Russia's prison population suffers from TB. Of those, 30% have MDR-TB.

Rising HIV and TB rates among the incarcerated are turning prison sentences into death sentences. Prison staff and inmates moving in and out of the system spread the disease to the general public.

Focusing on conditions inside Russia's prisons, particularly on the deadly interaction between TB and HIV, is not just about protecting the lives and dignity of prisoners. It is also crucial to limiting the spread of these infectious diseases beyond prison walls and saving lives everywhere.

Nina Schwalbe

Director, Public Health Programs

Open Society Institute, New York
020718
WJ020719

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