HIV - TB CO-INFECTION

As the HIV infection progresses, the CD4 lymphocytes decline in number and function. Therefore, the immune system is less able to prevent the growth and spread of the TB bacilli. As a result, disseminated and extra-pulmonary TB disease is more commonly seen in the later stages. Nevertheless, pulmonary TB is still the most common form of TB even in HIV-infected patients. Many studies have shown that pulmonary involvement occurs in 70-90 percent of all HIV/AIDS patients with TB.

In general, anti-TB treatment is the same for HIV-infected and HIV-uninfected TB patients, with the exception of the use of thiacetazone. Thiacetazone causes severe cutaneous reactions that may be fatal and hence should be avoided. Patients who complete treatment show the same clinical, radiographic and microbiological response to short-course treatment irrespective of whether they are HIV positive or negative. Self-administration of treatment is associated with higher case fatality rates. Directly Observed Treatment–short course (DOTS) is therefore even more important for HIV-infected TB patients. Treatment with DOTS for HIV-infected TB patients improves their quality of life, and also has been shown to prolong their life span. DOTS can prevent emergence of MDR -TB and reverse the trend of MDR-TB.

Tailoring the HIV surveillance system to the pattern of the epidemic in a country.  Behavioral surveillance for collection of information on risk factors and practices, STIs, etc.  Making best use of other sources of information to increase understanding of the HIV epidemic  and the behaviors that spread it. Better use of surveillance data to plan prevention and care interventions,  improve national response and to measure impact.

HIV Sentinel Surveillance is defined as "a system of monitoring HIV epidemic among specified  population groups by collecting information on HIV from designated sites (sentinel sites) over years,  through a uniform and consistent methodology that allows comparison of findings across place  and time, to guide programme response.