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  • TB-HIV BURDEN

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    The interaction between HIV and TB in co-infected persons is bidirectional and synergistic; on the one hand, HIV infection predisposes the development of active TB, and, on the other, the course of HIV-related immunodeficiency is worsened by active TB infection.

    Globally and in India, TB is the most common opportunistic infection seen in HIV patients and a leading cause of death in these patients. The lifetime risk of TB in immune-competent persons is 5-10%, whereas, in an HIV-infected person, the annual risk of TB is 5-15%. Thus, people living with HIV are 18 (15-21) times more likely to develop active TB disease than people without HIV.

     

    TB and HIV Burden Trends in India

    India is one of the WHO’s 30 high TB/HIV burden countries; of the 3 million TB incident cases, close to 54000 occurred in HIV-infected persons (See Table 1 for more details). TB and HIV are major public health challenges in India and are leading causes of mortality and morbidity among all other infectious diseases.

    Table 1: Comparison between global and Indian TB/HIV burden estimates, Source: WHO Global TB Report 2022
    INDICATORS GLOBAL ESTIMATES INDIA ESTIMATES
    Total TB Incidence 11 million 3 000 000
    HIV-positive TB Incidence 703 000 54 000
    HIV-positive TB Mortality 187 000 11 000
         

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  • HIV in TB Patients

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    The primary impact of HIV on TB is that the risk of developing TB becomes higher in patients with HIV. Overall, HIV-infected persons have an approximately 8-times greater risk of TB than persons without HIV infection. 

    Screen TB PLHIV patients for symptoms of TB and HIV

    Figure: Screening steps for TB - HIV patients

    Treatment for TB HIV Patients​

    • All TB patients who have been diagnosed and registered under NTEP should be referred for screening for HIV.
    • Referral of TB patients for screening for HIV and its recording & reporting is the responsibility of the Peripheral Health Institutions(PHI) where TB treatment is initiated.
    • TB patients diagnosed with HIV will receive the same duration of TB treatment with daily regimen as non-HIV TB patients.
    • TB patients must be referred to the nearest ART(Anti - Retroviral Treatment) centre for management of HIV.