Co-infection of Human Immunodeficiency Virus (HIV) and Tuberculosis: Indian Perspective.
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Date
2004-01
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Abstract
Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have resulted in a resurgence of tuberculosis the world over. Given that the South-East Asia Region of the World Health
Organization accounts for nearly 40 per cent of all tuberculosis (TB) cases globally and 18 per cent of the world’s HIV
infected also live in this region, the twin challenge of this “cursed duet” seems to be daunting. Treatment of patients coinfected
with HIV and TB in India is very difficult especially because there is very little co-ordination between the Revised
National Tuberculosis Control Programme (RNTCP) and HIV control. Clinical presentation of TB in early HIV infection
resembles that observed in immuno-competent persons. In late HIV infection, the clinical presentation of TB can be
atypical. Diagnosis of TB in HIV infected patients may be delayed because of atypical clinical presentation and involvement
of inaccessible sites and low sputum smear positivity. Rational management of patients co-infected with HIV and TB in
severely resource limited settings involves detailed history taking, thorough physical examination, clinical staging,
assessment of CD4+ T-lymphocyte count or total lymphocyte count and institution of antiretroviral drugs and antituberculosis
treatment using the directly observed treatment, short-course (DOTS) strategy. HIV infected patients respond
well to the standard anti-tuberculosis drug treatment regimens using the DOTS strategy. Thorough knowledge and familiarity
regarding the adverse drug reactions and drug-interactions between antiretroviral and anti-tuberculosis drugs is essential
for ensuring compliance and successful outcome.
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Keywords
Human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), pulmonary tuberculosis, extra-pulmonary tuberculosis, antiretroviral treatment, directly observed treatment, short-course (DOTS)
Citation
Sharma S K, Mohan A. Co-infection of Human Immunodeficiency Virus (HIV) and Tuberculosis: Indian Perspective. Indian Journal of Tuberculosis. 2004 Jan; 51(1): 5-16.