WHO estimates that one-third of the world's population is infected with Mycobacterium tuberculosis (Mycobacterium tuberculosis), but, on average, only one in ten infected people develop active TB disease. For people with healthy immune systems tubercle bacillus is often not present any particular risk, but tuberculosis in HIV-infected - is another matter.
Tuberculosis is sometimes called an opportunistic infection since its originators use that weakens the body's immune system, and lead to the development of a dangerous disease that affects the lungs and sometimes other organs
. Worldwide 14
. 8% of TB patients are also infected with HIV, and in some regions the proportion of patients diagnosed with tuberculosis and HIV infection is 50-80%
. In 2005, the number of people with the coinfection reached 1
. 39 million people, and now, apparently, it is gradually reduced
. However, tuberculosis is still the most common cause of death in AIDS patients - according to approximate data, it kills one in three people in whom HIV has developed into AIDS
. Currently, experts recommend that all HIV-infected people to be screened for TB
. Early treatment of this disease will not only avoid serious damage to the lungs and other internal organs, but also to prevent further damage to the immune system
The immune system - how it works?
Than that which can cause by itself an HIV infection.
The bacteria that cause tuberculosis, are transmitted by airborne droplets, for example when an infected person coughs or sneezes. It is unlikely that contamination can occur after a single contact with the tuberculosis pathogens. Moreover, TB is not transmitted through the touch, using a single dish, towel and other objects, together with the patient.
However, in regular contact with open tuberculosis patients
The open form of tuberculosis - to be treated in hospital
HIV-infected persons infected with tuberculosis is more likely than someone who does not have HIV. For people whose immune system has already greatly weakened, and there is an increased risk of infection in public places and areas with poor ventilation, even if they are near the source of the infection relatively short time.
HIV-infected patients should be sure to talk with your doctor about how to reduce the likelihood of becoming infected with tuberculosis, if they work in places of increased risk of infection, such as hospitals, clinics, nursing homes, prisons, homeless shelters, and so on.
HIV and TB
There are two main forms of TB: latent and active tuberculosis. If latent tuberculosis, the causative bacteria present in the body, but does not lead to the development of the disease and the appearance of any symptoms - a form of TB is very common. When active, or open form of tuberculosis, the bacteria multiply and lead to the development of the disease, which is dangerous for the patient, and contagious to others. In HIV-infected patients infected with TB bacteria, the probability of the development of open tuberculosis is 10 times higher than in healthy people. The risk becomes even greater when the following factors:
- Pregnancy;
- Malnutrition;
- Alcohol abuse;
- Drug use;
- Age younger than 5 years of age or over 65 years.
Symptoms
In HIV-infected TB patients are usually observed the same symptoms as that of the other patients:
- A cough that does not go away within two to three weeks;
- Coughing up phlegm or blood;
- Chest pain;
- Weakness and fatigue;
- Unexplained weight loss;
- Lack of appetite;
- Heat;
- Chills;
- Heavy sweating at night.
With HIV infection, these symptoms are very pronounced, and sometimes leads to the fact that the man almost loses its ability to function normally.
Diagnostics
All people who have been diagnosed with HIV, it is strongly recommended as soon as possible to make tuberculin skin test. Diagnosis of tuberculosis using Mantoux test can be difficult if the patient is infected with TB recently, and his immune system is very weakened by HIV infection - in such cases, the skin test can give false-negative result.
Typically, after the skin test shall be additional diagnostic procedures, such as chest X-ray, sputum and blood.
If the tests gave negative results in the future, you must re-take the survey once a year.
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Patients who gave birth after infection with HIV, their children should be tested for tuberculosis at the age of 9-12 months.
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HIV and tuberculosis: treatment
HIV-infected patients who are diagnosed with TB, should immediately begin treatment, regardless of whether they have an active form of the disease or not (with latent TB preventive treatment is appointed). Take medications as the doctor said, Otherwise, caused by tuberculosis bacteria can develop drug resistance.
Typically, tuberculosis
Tuberculosis - a full recovery is not guaranteed
HIV infection treated with various combinations of the following medications: ethambutol, isoniazid, pyrazinamide, and rifampin.
If the CD4 count of the patient is not too low, your doctor may recommend to undergo treatment of tuberculosis
Treatment of tuberculosis - a lengthy process and requires constant monitoring
before starting antiretroviral therapy. At the same time taking anti-TB and antiretroviral drugs there is an increased probability of occurrence of undesirable side effects.
Patients, especially those who live more than one, it is recommended hospitalization, on average, two to three weeks. During this time, TB can not be cured, but it becomes non-contagious. Before writing the patient, a number of tests to make sure that he really can no longer spread the infection.
For the treatment of latent TB infection in HIV-infected is usually given isoniazid for 6-12 months, and pyridoxine - is a form of vitamin B6, used to prevent peripheral neuropathy, which is one of the side effects of isoniazid. If isoniazid is ineffective, it can be assigned to rifampicin.
