-----Original Message-----
From: ACTION_Partners@yahoogroups.com
[mailto:ACTION_Partners@yahoogroups.com] On Behalf Of Louise Holly
Sent: 13 Juni 2008 17:23
To: ACTION_Partners@yahoogroups.com
Subject: [ACTION_Partners] FW: TB in BMJ

BMJ 2008;336:1330-1331 (14 June), doi:10.1136/bmj.39609.427338.DB


News


Coinfection of tuberculosis and HIV poses global threat


Peter Moszynski

1 London
The interaction between the twin pandemics of HIV and tuberculosis could
soon become a "threat to global health security," particularly with the
emergence of almost untreatable strains of tuberculosis, said experts at
this week's HIV and tuberculosis global leaders' forum at the United
Nations.

"Today, tuberculosis is one of the top 10 leading causes of death
globally, causing more than 4000 deaths every day," the UN secretary
general, Ban Ki-moon, told the meeting. "This is shocking: no one should
die of tuberculosis, a preventable and curable disease, in this
prosperous and technology rich 21st century."

"Despite the fact that HIV and tuberculosis frequently occur in the same
person, we continue to deal with the two diseases separately," Mr Ban
said. "Fewer than one third of all people living with HIV and
tuberculosis worldwide received appropriate treatment for both diseases
in 2007."

He called for "more collaboration between sectors, better coordination
between actors, greater investment in tuberculosis research and control,
and strengthened health systems" to tackle the problem.

Tuberculosis accounts for an estimated 250 000 deaths a year among
people with HIV and is the primary cause of death among people with HIV
in Africa. Because HIV weakens the immune system, people with the virus
are up to 50 times more likely to develop tuberculosis than people who
are HIV negative. Without proper treatment with tuberculosis drugs, most
people with HIV die within two to three months of becoming sick with
tuberculosis.

The meeting heard that the "outdated" drugs, diagnostics, and vaccines
available are not appropriate for people with HIV and tuberculosis
coinfection and so new tools are needed that work in the presence of
both diseases.

Kevin Decock, director of the World Health Organization's HIV
department, told the BMJ that the coinfection increasingly poses a
threat to the HIV negative population as well, particularly as resistant
and extensively resistant strains of tuberculosis become more
widespread.

Dr Decock warned that the people most at risk were health workers,
followed by international travellers, but the general population could
also be exposed to resistant strains if they became more common. In
parts of the former Soviet Union one in five patients with tuberculosis
in the general population has a resistant strain.

He said that if multidrug resistant tuberculosis merged with the HIV
pandemic "the consequences could be disastrous." He was concerned that
this could lead to a shift in the treatment of HIV patients: "It's one
thing asking health workers to care for patients when the only danger is
direct exposure to blood but quite another thing if they risk developing
a potentially incurable disease that is infectious simply through
inhalation."

________________________________

See "International conference calls for better prevention to contain
spread of AIDS" on bmj.com, doi: 10.1136/bmj.39608.490440.DB
<http://www.bmj.com/cgi/doi/10.1136/bmj.39608.490440.DB> .





No virus found in this incoming message.
Checked by AVG.
Version: 8.0.100 / Virus Database: 270.3.0/1504 - Release Date: 6/15/2008
5:52 PM