HIV/AIDS and Tuberculosis

Management of opportunistic infections (OIs) is the mainstay of HIV therapy. TB is the leading cause of morbidity and mortality in theAsia Pacific region. Therefore cost-effective management of TB is a critical issue. Dattatray Saple (India) presented compelling evidence for identifying TB in PLWHAs in India. 62/69 (90 percent) of patients were able to return to normal activities after three months of treatment. Treatment continued for 12 months despite the WHO's recommendation of six months of therapy. This was because greater than 50 percent of TB in PLWHAs is pulmonary and requires extended treatment. Despite this the WHO has still not revised its guidelines. A proposal to review treatment at six months and consider continuing treatment remains unresolved. Both Tasana Leusaree (Thailand) and Mao Tan Eang (Cambodia) described the development of operational and technical guidelines for management of TB in PLWHAs. Peter Deutchmann (Australia) outlined the issues of managing TB among refugees, highly mobile populations where treatment is likely to be irregular. Despite the challenges this group present, efficient cost-effective TB control is possible.