Time to act: save a million lives by 2015: prevent and treat among people living with HIV

Tuberculosis (TB) is the main cause of death in people living with HIV. This report is a call that TB should not be a death sentence for a two million people living with HIV and expected to die of TB between 2011 and 2015.

The report highlights the following related facts and drawn findings:

• every minute, three people living with HIV die from TB.
  
• in places where TB and HIV are prevalent, children living with HIV are highly vulnerable to becoming ill with and dying from TB.
• however, TB is preventable and curable with inexpensive medicines, yet current efforts to confront the deadly combination of TB and HIV are inadequate.
• every country seeking to prevent deaths from TB among people living with HIV needs to integrate HIV and TB services at every level of the health system.
• it needs also good systems for quickly tracking the numbers of people living with HIV who are becoming ill with TB.
• similarly, it needs to take measures to reduce TB exposure in places where people living with HIV may be concentrated.
  

The paper underlines that by testing for HIV and TB every 3 years, and scaling up methods that are already available, we can reduce deaths by 80%. Chiefly, the authors recommend that:

• all people who test positive for HIV and are also found to have TB should start TB treatment immediately.
• people living with HIV who are routinely exposed to TB should be protected by a daily dose of isoniazid.
• people living with HIV should receive antiretroviral therapy (ART) as soon as blood tests show that their CD4 count has dropped to 350 (i.e. the immune system is weak).