HIV & TB - "Double Trouble"
HIV/AIDS is the hallmark of the African TB epidemic, and is also why the incidence rates have exploded by 500% rather than reducing as intended by the MIllennium Goals.
HIV provides the greatest known factor for developing active TB from latent infection.
The two disease in deadly concert present enormous challenges to treatment:
Most HIV patients in Africa die from TB. In fact TB is actually the biggest killer of people living with HIV today.
Each disease in concert with the other accelerates in the other's progress. And even treating one of them using existing treatments can stimulate the development of the other. Often patients have to be taken off their HIV drugs whilst the TB is brought under control - a risky but often unavoidable procedure.
There is also no real evidence base for the treatment of both diseases together. Most treatments have been developed by expert opinion only, and this often varies between authorities. This is even more the case with the second line drugs used for treating DR-TB which have been far from acceptably tested for interactions with HIV medication.
The time required to diagnose and treat MDR-TB means that, unfortunately, the HIV virus has plenty of time to gain in strength.
All this information is not new. In 1991 an article was published in the Lancet, entitled "Is Africa Lost?" - suggesting that these two disease together could become "the greatest public health diseaster since the bubonic plague."