Management of TB in HIV Subjects, the Experience in Thailand

Abstract

Currently, tuberculosis (TB) remains a major public health threats of humankind. It has been occurred since antiquity and is the second communicable-disease cause of death after the human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS). Of the mycobacterial diseases, TB is by far the most important because of its most virulence. Most of the disease and nearly all of the deaths occurs in the developing countries. Coinfection with HIV/AIDS and TB represents a public health crisis worldwide. An estimated 2 billion people worldwide carry latent infection and more than 8 million persons develop active TB each year. Approximately, 3 million people per year die from TB (WHO, 2010). Various comorbidities, especially the immunocompromised statuses will accelerate the TB sickness and deaths. The prevalence of primary drug(Jiang et al., 2011) and multidrugresistant (MDR) (Wells, 2010) pulmonary TB among the immunocompromised populations is globally increased. In Thailand, total-estimated TB cases is more than 140,000, now ranking 18 of the 22 high-burden countries of the world (WHO, 2010). The clinical features of active TB are very highly variable, depend on the immune status of the host and the site and extent of disease. New diagnostic, therapeutic, preventive and control strategies for TB are heavily investigated throughout the world. How we can rapidly diagnose TB within few hours and how we can shorten the treatment regimens to weeks or days. World elimination of TB is expected to occur in 2050 when the incidence is 1 patient per 1 million populations per year (WHO, 2010).