One in three people worldwide are infected with tuberculosis (TB). The risks of HIV-TB co-infection among PLHIV dramatically increases as dormant TB infection turns active and becomes life-threatening.
Extra-pulmonary TB is a major challenge as its symptoms are latent, making identification at an early stage difficult. Vulnerability of people living with TB increases for those from lower socio-economic backgrounds, particularly since diagnosis and initiation of early treatment becomes more difficult.
Among PLHIV, these challenges are enhanced as the focus of ART Centres is on monitoring CD4 counts and providing HIV treatment. As symptoms of TB infection are often latent, it is often missed and becomes deadly. One quarter of all HIV deaths in India are from TB co-infection. Infected with HIV, the body’s weakening immune system leaves it dangerously vulnerable to TB.
For patients starting HIV treatment, TB infection can develop into a dangerous condition called TB-IRIS (Immune Reconstitution Inflammatory Syndrome). As the immune system of such patients recover due to ART, it responds to TB with an overwhelming inflammatory response that can be life threatening.
The Indian Government and other stakeholders can together on World TB Day to chart a plan to end TB in the country. For success, we must tackle HIV-TB co-infection head on. We must expand investment in treatment literacy among PLHIV on TB-HIV co-infection, and further resources for TB treatment and monitoring are required. These priorities must be addressed with urgency, so that co-infected PLHIV may be cured of TB, saving their lives and protecting their right to health.
The writer of this blog, Manoj Pardeshi, is the General Secretary of the National Coalition of People living with HIV in India (NCPI+).
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