Question

HIV & Tuberculosis - Is There A Link?

Dr.Lt Col Adnan Masood · Accepted Answer

HIV and tuberculosis (TB) are two life-threatening and common diseases in the world. The two diseases are very closely connected so much so that their occurrence is normally labelled as a co-epidemic. In most cases tuberculosis is found to be the most transmissible contagion in HIV-Immunocompromised victims, proving to be the cause of their death.

What is HIV?
Human Immunodeficiency Virus, more commonly known by its abbreviation HIV, is a virus that attacks the immune system, which is the body's natural defense against illnesses. The virus terminates a kind of white blood cells (WBCs) in the immune system known as the T-helper cell also known as CD4 cells. This virus then proceeds to duplicate itself within these cells.

As HIV reduces the T-helper cells, by duplicating at an increasing rate, it slowly breaks down the patient s immune system. This leaves the individual susceptible to other deadly diseases such as tuberculosis. HIV infection is a permanent disease with three phases of progression. HIV medications can reduce or stop the evolution of the disease from one phase to another. The treatment can also decrease the chances of spreading HIV to other people.

What is tuberculosis (TB)
Tuberculosis is a transmittable disease triggered by the presence of bacterium known as Mycobacterium tuberculosis. It is still considered a deadly disease in most developing countries where treatment is scarce. Generally, TB affects the lungs but it can also affect other parts of the body. Symptoms include coughing with blood, fever, night sweats and loss of weight.

The relation between TB and HIV
In second world countries, most patients infected with HIV suffer from TB as the initial indicator of AIDS. Tuberculosis can occur at any phase of the HIV infection. The danger and severity of tuberculosis rises rapidly after infection with HIV. Even though tuberculosis can be a fairly primary indicator of HIV infection, it is imperative to observe that the risk of tuberculosis increases as the CD4 cell count reduces along with the progression of the HIV infection.

Treatment
Positive treatment for TB usually entails 6 months of rigorous therapy. HIV patients with TB usually respond well to this therapy, if the regimen comprises INH and a rifamycin for the period of TB therapy and cure. TB generally reappears when the immune system is unable to respond to stop the development of mycobacteria. The cytokine IFN- plays a key role in the response of the immune system all through the contagion.
HIV and TB infections area two-directional communication of the two pathogens. TB is one of the main causes of disease and fatality among patients with HIV in Africa and other severely affected regions. With almost a 50% kill rate around the world, raising awareness about this disease and consulting doctors when signs or symptoms appear is vital in reducing the extent of this epidemic.

Rifampicin- HIV treatment are complicated by the fact that one of the key drugs used in TB treatment, rifampicin, reduces blood levels of nevirapine (Viramune) by 30 to 55% and also reduces levels of most protease inhibitors.

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HIV & Tuberculosis - Is There A Link?

HIV - Understanding Its Relation With Tuberculosis!