Alarmed that more than 60 per cent of the estimated 1.20 lakh HIV-associated TB cases in the country are out of its health welfare schemes, the Government has kicked off a project to identify TB cases in 30 high-burden HIV treatment centres across five endemic States Tamil Nadu, Andhra Pradesh, Telengana, Karnataka and Maharashtra.
Once identified, they will be offered adequate treatment. Just 37 per cent of the estimated 1.20 lakh HIV-associated TB cases in the country have been notified to the Government’s TB control programme in 2013. Moreover, the treatment success rates among HIV persons infected with TB or vice versa are lower at 77 per cent against more than 85 per cent in non co-infected.
late diagnosis of TB and/or HIV, non initiation of TB preventive therapy, inadequate TB treatment regiment, poor patient support system such as adequate nutrition and adherence support among such patients are being considered as the major reasons for high mortality.
“In view of these challenges, it has been felt to implement a comprehensive strategy to reduce the burden of TB among people living with HIV AIDS and vice versa,” the official noted.
The project ‘innovative intensified TB case finding and treatment at high burden ART centres’ has been launched with technical support from the WHO, RNTCP-NACP in 30 ART centres in the five high endemic States.
Under the scheme, at the ART centres, HIV positive individuals will be offered TB services, around 15,000 TB-HIV co-infected patients will receive quality first line anti-TB drugs. “This would reduce deaths and improve quality of life in these patients,” the official added.
Under the project, steps will be initiated to reduce risk of acquiring TB in HIV positive individuals through implementation of air borne infection control measures at these ART centres.
TB is the most common opportunistic infection and leading cause of death among people living with HIV AIDS. As per the WHO Global TB report, after South Africa, India has the highest global burden of HIV associated TB. An estimated 3800 people die every year among these TB-HIV co-infected patients.
Moreover, although 92per cent of the notified co-infected patients received Anti-Retrovial Therapy (ART) and Cotrimoxazole preventive therapy, death continues to be higher at 13 per cent against 4 per cent in non co-infected patients.