Tuberculosis and HIV have been closely entwined for decades. Tuberculosis has become the leading killer of people with HIV, and the overlapping epidemics have had a devastating impact on TB morbidity, mortality and control.
More than 11 million adults living with HIV/AIDS are also infected with TB, and in some countries more than 50 percent of those with active TB are co-infected with HIV.
In sub-Saharan Africa, HIV is fuelling the TB epidemic; the incidence rate of TB increased from 146 per 100,000 in 1990 to 345 per 100,000 in 2003.
The synergy between HIV and TB requires a coordinated approach to diagnosis and treatment of the two diseases, a fundamental component of programs supported by the International Center for AIDS Care and Treatment (ICAP) at Columbia University's Mailman School of Public Health.
ICAP's philosophy regarding TB/HIV care mirrors that of its overall approach to care and treatment of HIV/AIDS: it should be high-quality and as uncompromising as possible; it should be multidisciplinary in nature, drawing on the skills and resources of TB and HIV programs and providers; it should empower the patient as a partner in his/her care; it should involve the patient's family; and community supporters and peer workers should be included in the care plan wherever possible.
ICAP supports collaborations between National TB and National HIV programs, and integration of TB and HIV services at health care delivery sites, supporting implementation and scale-up of quality care for TB/HIV co-infected patients. ICAP currently has programs on TB/HIV collaboration and integration in multiple countries including Ethiopia, Rwanda,
Mozambique, and South Africa, with plans for future programming in Tanzania.
| TB/HIV articles (PDFs) |
| Recent Articles |
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| Mtei et al. High rates of clinical and subclinical tuberculosis among HIV-infected ambulatory subjects in Tanzania. CID, 2005. |
166 KB |
| Lawn et al. Immune reconstitution disease associated with mycobacterial infections in HIV-infected individuals receiving ARVs. Lancet ID. 2005 |
282 KB |
| Treatment of latent TB infection in HIV infected persons. Cochrane Review 2005. |
499 KB |
| ARTCC. Incidence of HIV among HIV-infected patients receiving HAART in Europe and N America. CID 2005. |
133 KB |
| Lawn et al. TB among HIV-infected patients receiving HAART. AIDS 2005 |
168 KB |
| Cotrimoxazole in TB/HIV |
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| Godfrey-Faussett. District-randomized phased implementation: strengthening the evidence base for CTX for HIV-positive tuberculosis patients. AIDS 2003. |
58.5 KB |
| Zachariah et al. Voluntary counseling, HIV testing, and adjunctive CTX reduces mortality in tuberculosis patients in Thyolo, Malawi. AIDS 2003. |
105 KB |
| Wiktor et al. Efficacy of TMP-SMX prophylaxis to decrease morbidity and mortality in HIV-1 infected patients with TB in Abidjan: a randomized controlled trial. Lancet 1999. |
1.37 MB |
| Immune Reconstitution Inflammatory Syndrome |
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| Lawn et al. Immune reconstitution disease associated with mycobacterial infections in HIV-infected individuals receiving ARVs. Lancet ID. 2005. |
282 KB |
| Narita et al. Paradoxical worsening of TB following ART in patients with AIDS. AJRCCM 1998. |
54.1 KB |
| Schluger et al. Reconstitution of immune responses to tuberculosis in patients with HIV infection who receive antiretroviral therapy. Chest 2002. |
130 KB |
| Shelburne et al. Immune Reconstitution Inflammatory Syndrome. Medicine 2002. |
1.32 MB |
| Latent TB Infection and INH Preventive Therapy |
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| Treatment of latent TB infection in HIV infected persons. Cochrane Review 2005. |
499 KB |
| Bell et al. Tuberculosis preventive therapy for HIV-infected people in sub-Saharan Africa is cost-effective. AIDS 1999. |
154 KB |
| Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial. Bulletin WHO, 1982. |
461 KB |
| Casado et al. Risk factors for development of tuberculosis after isoniazid chemoprophylaxis in HIV-infected patients. CID 2002. |
78.9 KB |
| Gordin et al. A controlled trial of isoniazid in persons with anergy and HIV infection who are at high risk for tuberculosis. New Engl J Med 1997. |
94.2 KB |
| Hawken et al. Isoniazid preventive therapy for tuberculosis in HIV-1-infected adults: results of a randomized controlled trial. AIDS 1997. |
248 KB |
| Johnson et al. Duration of efficacy of treatment of latent tuberculosis infection in HIV-infected adults. AIDS 2001. |
199 KB |
| TB/HIV Integration and Co-management |
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| Burgess et al. Integration of tuberculosis screening at an HIV voluntary counseling and testing centre in Haiti. AIDS 2001. |
134 KB |
| Coetzee et al. Integrating tuberculosis and HIV care in the primary care setting in South Africa. Trop Med and Int Health 2004. |
61.9 KB |
| Karim et al. Implementing antiretroviral therapy in resource-constrained settings: opportunities and challenges in integrating HIV and TB care. AIDS 2004. |
80.8 KB |
| Godfrey-Faussett. How HIV voluntary testing can contribute to TB control. Bulletin WHO 2002. |
318 KB |
| Miti et al. Integration of TB treatment in a community-based home care programme for persons living with HIV/AIDS in Ndola, Zambia. Int J Tuber Lung Dis 2003. |
92.7 KB |
| TB/HIV Co-Treatment |
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| Friedland et al. Utility of TB DOT programs as sites for access to and provision of ART in resource-limited countries. CID 2004. |
103 KB |
| Farmer et al. Community-based treatment of advanced HIV disease: introducing DOT-HAART. Bulletin WHO 2001. |
274 KB |
| Updated guidelines for the use of rifamycins for TB treatment in HIV-infected patients taking protease inhibitors or NNRTIs. CDC 2004. |
158 KB |
| Schluger. Issues in the treatment of active TB in HIV-infected patients. CID 1999. |
140 KB |
| Prevention and treatment of TB among patients infected with HIV: principles of therapy and revised recommendations. MMWR 1998. |
743 KB |
| TB/HIV Morbidity and Mortality |
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| Seyler et al. Risk factors for active TB after ART initiation in Abidjan. Am J Resp Crit Care Med 2005. |
72.1 KB |
| Badri et al. Association between TB and HIV disease progression in a high TB prevalence area. Int J Tuber Lung Dis 2001. |
293 KB |
| Dheda et al. Outcome of HIV-associated TB in the era of HAART. JID 2004. |
118 KB |
| Girardi et al. Impact of combination ART on the risk of TB among persons with HIV infection. AIDS 2000. |
142 KB |
| ARTCC. Incidence of HIV among HIV-infected patients receiving HAART in Europe and N America. CID 2005. |
133 KB |
| Lawn et al. TB among HIV-infected patients receiving HAART. AIDS 2005. |
72.4 KB |
| Borgdorff et al. Interventions to reduce TB mortality and transmission in low- and middle-income countries. Bulletin WHO 2002. |
355 KB |
| Mukadi et al. TB case fatality rates in high HIV prevalence populations in sub-Saharan Africa. AIDS 2001. |
177 KB |
| Santoro-Lopes et al. Reduced risk of TB among Brazilian patients with advanced HIV infection treated with HAART. CID 2002. |
76.8 KB |
| TB/HIV Epidemiology |
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| Bowen et al. HIV seroprevalence by anonymous testing in patients with MTb and in TB contacts. Lancet 2000. |
325 KB |
| Lawn et al. TB among HIV-infected patients receiving HAART. AIDS 2005 |
171 KB |
| Range et al. Trends in HIV prevalence among TB patients in Tanzania, 1991-1998. Int J Tuber Lung Dis 2001. |
336 KB |
| TB/HIV Infection Control |
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| Harries et al. Practical and affordable measures for the protection of health care workers from TB in low income countries. Bulletin WHO 1997. |
722 KB |
| TB Screening & Case Finding in HIV-infected Patients |
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| Hudson et al. Diagnosing HIV-associated TB: reducing costs and diagnostic delay. Int J Tuber Lung Dis 2000. |
147 KB |
| Mohammed et al. Screening for TB in adults with advanced HIV infection prior to preventive therapy. Int J Tuber Lung Dis 2004. |
56 KB |
| Mtei et al. High rates of clinical and subclinical tuberculosis among HIV-infected ambulatory subjects in Tanzania. CID, 2005. |
166 KB |
| Nchega et al. TB active case finding in MTCT programs in Soweto, South Africa. AIDS 2003. |
268 KB |
| Classic TB/HIV Articles |
Size |
| Wiktor et al. Efficacy of TMP-SMX prophylaxis to decrease morbidity and mortality in HIV-1 infected patients with TB in Abidjan: a randomized controlled trial. Lancet 1999. |
1.37 MB |
| Narita et al. Paradoxical worsening of TB following ART in patients with AIDS. AJRCCM 1998. |
54.1 KB |
Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial.
Bulletin of the WHO, 1982. |
461 KB |
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