Because Latin American doctors are misdiagnosing these patients, treatments that can cure or reduce illness and prevent death are not being administered properly. As a result, the HIV epidemic has contributed to a global resurgence of tuberculosis.
Tuberculosis is the leading cause of death among HIV patients which is why this problem is being addressed by the Pan American Health Organization and World Health Organization this week. These groups are leading a charge in an area that has the highest percentage of HIV and tuberculosis co-infection outside of sub-Sarahan Africa by hosting meetings calling for more integration between independent efforts to curb HIV and tuberculosis.
“HIV and tuberculosis are both preventable,” said Dr. Mirta Roses, director of the Pan American Health Organization. “For people who are already infected, HIV is treatable and tuberculosis is curable. With the proper coordination, we can do a lot to improve the lives of all these patients.”
Tuberculosis is a bacteria that, if the body’s immune system is functioning properly, may not show any symptoms. However, if the bacteria takes over the immune system it can spread and grow in the lungs. That may cause a cough that can last longer than two weeks, cause pain the chest and result in coughing up blood or sputum.
An HIV patient’s immune system can become so compromised that it cannot effectively combat bacterial infections. If a patient who has been carrying the tuberculosis bacteria and has never shown symptoms develops HIV, they have a very high chance of developing a severe infection.
It can be difficult to diagnose tuberculosis in HIV patients.
Tuberculosis is normally detected by injecting the skin with a protein found in the bacteria. If the skin swells, the test is positive and the bacteria is likely present. However, the immune system of HIV patients can be so weak that it might not be able to react to the tuberculosis protein, giving a false negative to the test.
Treatment of tuberculosis in non-HIV patients is relatively straightforward. But in HIV patients, it is complicated. They are on a number of drugs, some of which counteract with traditionally effective tuberculosis treatments. As a result, the drugs become useless and can even do harm to the patient. As such, tuberculosis in HIV patients has to be treated differently.
Tuberculosis and HIV co-infections are high in Brazil, Guatemala, Jamaica, Haiti, Honduras, El Salvador, and Mexico. In these and other Latin American countries, treatment for tuberculosis is free and widely available. But medications are not available for HIV patients for whom the standard tuberculosis drugs are not effective.
The Pan American Health Organization is hoping to make alternative treatments available.
Soni Sangha is a freelancer based in New York City.