TB/HIV Co-infection

HIV and tuberculosis are commonly called the “deadly duo” because HIV weakens the body’s defense system, making people more prone to developing TB. People with HIV are up to 50 times more likely to develop TB in a given year than HIV-negative people.[1] TB bacteria also accelerate the progression of HIV to AIDS and, as a result, TB is the leading cause of death for people with HIV. Globally, an estimated 13 percent of TB cases are co-infected with HIV.[2] Without proper treatment, 90 percent of people living with HIV die within months of contracting TB.[3] The current challenge is to find ways of preventing both TB and HIV, and to improve diagnosis and management of co-infection.

MSH collaborates with national TB programs and national AIDS control programs in ten nations throughout Africa, Latin America, and the Caribbean. We work with stakeholders to develop TB/HIV policy guidelines and implement standard operating procedures for improved detection and treatment of TB among people living with HIV. We also train and supervise local health workers to improve their ability to provide clinical care and manage TB/HIV co-infection.

MSH supports different models of facility-based care for TB and HIV and AIDS ranging from vertical services to fully integrated. Our interventions help reduce TB/HIV co-infection and improve treatment for co-infected patients. In Ethiopia, for example, we have helped the Ministry of Health improve community-level access to care by decentralizing TB/HIV services from hospitals to health centers. Our field teams have addressed Ethiopia’s human resource needs by training mid-level health care workers to provide care for TB/HIV co-infected patients, thereby reducing the burden of care on physicians. MSH has also worked with local partners to strengthen referral systems and implement standard operating procedures and standards of care to improve TB/HIV service quality. Together, these interventions helped Ethiopia’s Ministry of Health increase the percentage of TB patients tested for HIV from 16 percent in 2007 to 92 percent in 2012, increase the portion of HIV patients screened for TB from 25 percent in 2007 to 92 percent in 2012,[4] and decrease the nation’s TB/HIV co-infection rate from 31 percent in 2007 to below 15 percent in 2012.[5]

[1]WHO 2013
[2]PEPFAR 2012
[3]WHO 2013
[4] Ethiopian Federal Ministry of Health/Ethiopian Health & Nutrition Research Institute National. TB/HIV surveillance report, 2012
[5] Ethiopian Federal Ministry of Health Annual Report, 2007