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Navigable Slide Index
- Introduction
- The statistics of HIV-TB for 2010
- Over 80% of HIV-TB in sub-Saharan Africa
- Where we are and where we are going with HIV-TB
- Historical context: 1970s - 1980s
- Sharp increase in global TB in 1980s
- SIV caused HIV
- June 5, 1981, the AIDS epidemic officially began
- HIV-AIDS by December 2010 (~30 years later)
- Regional HIV and AIDS statistics and features
- Clinical WHO staging and relation to CD4 count
- The TB-HIV interaction
- The tubercle bacillus
- Reasons for increase in risk of active TB
- Risk of TB in persons with M. tuberculosis
- Risk of TB increases as CD4 count decreases
- TB incidence rates in HIV-infected patients
- Growth in TB incidence in Africa, 1980-2004
- TB with HIV is highest in sub-Saharan Africa
- Framework for TB control: 1994 "DOTS"
- Targets for TB control
- Global progress: fifteen years
- Progress in Africa region
- Effect of HIV on TB control
- Programmatic effects
- Notified TB cases in Malawi: 1985 - 2005
- Malawi: TB and HIV interaction
- TB increase lags behind HIV increase
- HIV increases the number of women with TB
- The women's TB ward in QECH, Malawi: 1995
- Reasons for an increase in PTB suspects
- Hot spots of TB transmission
- Stigma
- HIV weakens health care delivery
- Survey in 40 Malawian hospitals: 1999
- Patient management
- Difficult diagnosis
- Advancing HIV immune suppression
- Smear-negative PTB
- Normal CXR in PLHIV with TB
- Slim disease
- Diagnosis of TB in HIV-positive children
- Deaths in new sm+ve PTB patients
- Deaths in HIV-related TB
- High rate of recurrent TB after treatment
- Re-infection or re-activation?
- HIV facilitates spread of drug-resistant TB
- HIV derails achievement of targets
- How to decrease the joint burden of HIV / TB?
- Joint collaboration
- The interim policy: Jan 2004
- The WHO 12 points policy package
- Mechanisms for collaboration
- Program collaboration
- Strong health systems
- Listen to what co-infected patients want
- Prevent TB in HIV-infected persons
- The 3 "I"s: interdependent and complimentary
- Key components
- Care at an ART clinic in Malawi
- TB symptom screen
- Referring for TB investigations
- Usual way of investigating for tuberculosis
- Diagnosis of TB "Achilles Heel"
- Isoniazid preventive therapy (IPT)
- Guidelines for IPT
- Progress with ICF and IPT
- New ways of diagnosing TB in HIV settings (1)
- New ways of diagnosing TB in HIV settings (2)
- Empirical TB treatment for HIV infected patients
- Think "outside the health sector"
- WHO interim policy in hindsight
- TB rates in HIV-infected patients in Cape Town
- The current problem in sub-Saharan Africa
- ART initiation for all PLHIV with low CD4 count
- Early vs. standard ART in HIV-infected adults
- A bolder approach is needed
- Treating HIV in patients with TB
- Stages from diagnosis to HIV-TB treatment
- 2002: the rapid HIV test
- Things to consider
- Cotrimoxazole preventive therapy (CPT)
- Antiretroviral therapy (ART)
- WHO recommendations: ART guidelines in 2010
- The CAMELIA trial
- Recent published papers regarding ART
- WHO statistics in 2010: 8.8 million TB cases
- We need to do better
- Do we have the money?
- Bold vision
- Thank you
Topics Covered
- Global HIV-Tuberculosis
- Historical context
- Interaction between the two pathogens (HIV and Mycobacterium tuberculosis)
- The Framework for Tuberculosis Control "DOTS"
- The effect of HIV on Tuberculosis control with respect to programme delivery and patient management
- The health sector response
- The WHO Interim Policy on decreasing the joint burden of HIV and tuberculosis
- Mechanisms for collaboration
- Preventing TB in HIV-infected persons
- Treating HIV in patients with TB
- Conclusion
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Talk Citation
Harries, A.D. (2013, February 28). Impact of HIV on tuberculosis in the developing world and how to manage it [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 21, 2024, from https://doi.org/10.69645/TTGC3081.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Anthony D. Harries has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Impact of HIV on tuberculosis in the developing world and how to manage it
Published on February 28, 2013
49 min
A selection of talks on Microbiology
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