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close this bookTuberculosis Control in Refugee Situations - An Inter-Agency Field Manual (World Health Organisation, 1997, 72 p.)
close this folder1. TUBERCULOSIS (TB)
View the document1.1 Global Burden of TB
View the document1.2 Natural History of TB
View the document1.3 TB in Refugee Situations
View the document1.4 HIV/TB

1.4 HIV/TB

In some countries (particularly sub-Saharan Africa), 30-70% of TB patients are infected with HIV. Compared with a non-HIV infected person, an HIV infected person is 25 times more likely to progress from infection to active disease. As well as being at greater risk of developing severe disease, HIV infected people are also at greater risk of developing serious side-effects from TB drugs.

TB is the leading cause of death amongst people infected with HIV. When a HIV /AIDS prevention programme is established in a camp or emergency setting, education on HIV prevention should be provided to TB patients through the TB clinics. TB clinics are also suitable places for the distribution of condoms.

TB patients with concurrent HIV infection respond well to TB treatment but may have more side effects from TB drugs. If a TB patient is infected with HIV, monitor for opportunistic infections, and refer to a doctor for assessment.

TB patients should not be routinely tested for HIV.

The symptoms and signs of TB in patients who are infected with HIV are the same as in non-infected individuals. Spread from the lungs to other parts of the body is common and may result in the severer forms of TB (e.g. meningitis). This is particularly so in children.

Thioacetazone should be avoided because severe, even life-threatening, reactions occur more frequently in HIV co-infected individuals. It is not recommended for use in refugee situations.

RESOURCES

Crofton J, Home N, Miller F. Clinical Tuberculosis, MacMillan,
TALC and IUATLD, 1992
Harries AD, Maher D. TB/HIV: a Clinical Manual. Geneva: WHO: 1996.
WHO / TB / 96.200.


Figure 1 The Natural History of Tuberculosis

Adapted from Crofton J. Et al. Clinical Tuberculosis


Figure 2 Classification of TB