In-depth: TB and HIV: Deadly allies

GLOBAL: TB and HIV co-infection crisis a bigger threat

Drug resistant TB is still a major challenge
JOHANNESBURG, 24 March 2009 (IRIN) - One in four tuberculosis (TB) deaths in the world is HIV-related, twice as many as previously thought, according to a new report by the World Health Organisation (WHO).

The Global TB Control report, released on 24 March, World TB Day, noted that in 2007 there were an estimated 1.37 million new cases of tuberculosis among HIV-infected people and 456,000 deaths - almost double the figures published in previous reports.

Yet WHO warned that this did not mean the numbers had doubled between 2006 and 2007, but rather indicated an "improvement in the quality of the country data, which are now more representative, and available from more countries than in previous years."

According to the report, African countries accounted for most of the HIV-positive TB cases, followed by the South-East Asia Region, while South Africa accounted for a third of co-infected cases in the African Region.

There was a sharp increase in HIV testing among people being treated for TB, especially in Africa: in 2004, just four percent of TB patients in the region were tested for HIV, but in 2007 that number rose to 37 percent, with several countries testing more than 75 percent of TB patients for HIV infection.

As a result, more people received treatment - in 2007, 200,000 HIV-positive TB patients were enrolled in co-trimoxazole treatment to prevent opportunistic infections and 100,000 were receiving antiretroviral therapy.

The report warned that TB/HIV co-infection and drug-resistant forms of TB presented the greatest challenges. In 2007 an estimated 500,000 people had multidrug-resistant TB (MDR-TB), but less than one percent of them were receiving treatments known to be based on standards recommended by WHO.

Another major concern was the increasing lack of funding. Ninety-four countries, in which 93 percent of the world's TB cases occur, provided complete financial data for the report; the funding shortfall, if these 94 countries are to meet the 2009 milestones in the Stop TB Partnership's Global Plan to Stop TB, has risen to about US$1.5 billion.

Full funding of the Global Plan could halve TB prevalence and deaths by 2015.

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