Tuberculosis Testing and Treatment Should Be Tied to HIV Treatment
HIV infected patients have a high risk of acquiring tuberculosis (TB), an AIDS-defining opportunistic infection. Recently, there has been a call for TB testing and treatment to be linked with HIV treatment to help fight both diseases. This is especially important in areas such as Africa that have a high prevalence of both HIV and TB.
Recently, strains of multi-drug resistant TB (MDR-TB) and extremely drug resistant TB (XDR-TB) have been on the rise in different parts of the world and represent a serious problem for immune-compromised individuals, especially people with HIV.
Because TB is the number one cause of death of people infected with HIV, it is important that TB testing become routine for HIV patients. Currently, TB testing is efficient, but results may not be quick enough for individuals with highly compromised immune systems. Usually, it takes 24 to 48 hours to confirm TB test results. A urine-based TB test currently in development may provide instant results that would allow TB infected individuals to have quicker access to treatment.
Treatment for TB/HIV coinfected individuals is especially difficult, and often TB treatment is overlooked in HIV patients. Treating both conditions is difficult due to drug interactions and side effects. However, dual treatment is imperative in TB/HIV infected patients, especially given the increase in MDR-TB and XDR-TB cases.
For more information about TB treatment, please see the Treatment of Tuberculosis Guidelines.
Twin Pregnancies Increase Risk of Mother-to-Child HIV Transmission
A recent study conducted by researchers at the University of Paris concluded that twin pregnancies carry a greater risk of mother-to-child HIV transmission compared to single pregnancies. The study examined mother-to-child transmission among HIV infected pregnant women from the French Perinatal HIV Cohort.
Data from the study show that before the introduction of highly active antiretroviral therapy (HAART), the mother-to-child HIV transmission rate in twin pregnancies was two to three times greater than in single pregnancies. Also, pregnancies in which the membranes surrounding a fetus broke prematurely were associated with a 4.5-fold increase in the risk of mother-to-child HIV transmission.
However, the study also showed that since HAART was launched in 1997, mother-to-child transmission rates have drastically reduced and are now similar for both single and twin pregnancies.
In response to the results of this study, the investigators concluded that doctors treating HIV infected women who are pregnant with twins should begin HAART no later than the beginning of their second trimester. This will greatly reduce the risk of mother-to-child HIV transmission through rupture of the membranes or premature delivery, both of which are more common with twin pregnancies.
For more information, read the AIDSinfo fact sheets on HIV During Pregnancy, Labor and Delivery, and After Birth and recommended HAART regimens.