Eleven million adults are now estimated to be co-infected with HIV and tuberculosis, delegates to the recent 15th International AIDS Conference learned. Many of these people live in sub-Saharan Africa, where 70% of those suffering from tuberculosis are also HIV positive, according to Dr. Papa Salif Sow, a professor of infectious diseases at Dakar University in Senegal. HIV suppresses the immune system and increases susceptibility to whatever infections happen to be prevalent. With each active or re-activated case of tuberculosis, HIV worsens.
Sow urged vigorous screening for tuberculosis and active prophylactic treatment for TB of all HIV-positive people, to delay onset of HIV, to reduce morbidity and mortality, and to prevent transmission.
This tactic proved effective in a 2-centre study in Cape Town where isonizide (or a placebo) was given prophylactically to HIV-infected children aged 8 weeks or older. Between January and December 2003, there was a death rate of 14.1% among those taking the drug, and 76.2% among the placebo group.
At a prenatal clinic in South Africa, almost 36% of women are HIV positive, and 60% of those with active tuberculosis are co-infected with HIV. Their once-per-day observed treatment regimen (DOT) also allows the doctors to treat their HIV.
Dr. Ayesha Khorsany, who operates the clinic at Kwa Zulu Natal, told CMAJ that most new cases of AIDS are in young women. Worldwide, among people younger than 24, girls and women make up nearly two-thirds of those living with HIV, the UN reports. In South Africa, Khorsany attributes this to the “sugar-daddy effect.” Older men offer girls the 3 Cs: credit cards, a car and cell phone. The myth that having sex with a virgin can cure the disease is also still rampant. The clinic is pursuing an intensive HIV prevention program, stressing the methods of acquiring HIV/AIDS.
The International AIDS Conference, held July 11–16 in Bangkok, Thailand, attracted 17 000 delegates from 162 countries. The United Nations estimates 38 million people are now HIV positive; AIDS has killed 20 million people since 1981. — Dr. M. J. Ferrari, Ottawa
Figure. Profile of AIDS: Dkshinamurthy, 40, an HIV-positive patient in India. Photo by: Canapress