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  • Title: Association between HIV and tuberculosis: technical guide.
    Journal: Bull Pan Am Health Organ; 1993; 27(3):297-310. PubMed ID: 8220525.
    Abstract:
    A 1992 PAHO meeting of AIDS and tuberculosis (TB) specialists resulted in guidelines for health professionals on diagnosis, treatment, and follow up of TB associated with HIV infection or AIDS. They listed procedures to treat persons with active TB and infected with HIV/AIDS. Other procedures addressed reduction of transmission of Mycobacteria tuberculosis to HIV positive persons and to the general population, of the incidence of reactivation of latent TB in HIV-positive persons, and of primary active TB in HIV-positive persons exposed to M. tuberculosis. They developed 1 algorithm for treating HIV-positive persons in areas of low TB transmission (= or .5% annual risk of infection equaling about 25 confirmed bacilliferous pulmonary cases/100,000 persons/year) and another algorithm for areas of high transmission. In areas of high transmission, the algorithm excludes the purified protein derivative of M. tuberculosis skin test. Both algorithms recommend chemoprophylaxis for HIV-positive persons not identified as having TB. Chemoprophylaxis is the same for both asymptomatic HIV-positive persons and persons with AIDS. Clinicians should request HIV serodiagnostic tests for every person with pulmonary or extrapulmonary TB. They should provide appropriate counseling prior to and after the HIV test. HIV-positive TB patients should receive the same TB treatment as those not infected with HIV. The 1st phase of TB treatment comprises daily simultaneous administration of 1 dose of rifampicin, isoniazid, pyrazinamide, and ethambutol for 60 days. The 2nd phase consists of 1 dose of rifampicin and isoniazid 2 times/week for a total of 40 doses. Other recommendations included increased interaction between AIDS and TB programs, training on AIDS and TB and related matters for health personnel, regulations ensuring diagnosis of simultaneous infection and on chemoprophylaxis and treatment, and improve AIDS programs and TB programs in all countries.
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