Govt to club AIDS, TB-control drives

NEW DELHI: Tuberculosis is the biggest killer of HIV patients in India. According to the National AIDS Control Organisation (Naco), over 60% of HIV patients contract and ultimately die of TB.

Faced with this double blow, India has now integrated the national AIDS and TB control programmes and is all set to launch a unique package under which all patients diagnosed with TB will be offered free HIV testing in the country’s 4,567 Integrated Counselling and Testing Centres (ICTC).

Kounteya Sinha for Times of India.

Once detected with co-infection by both HIV and TB, the patient will be provided a prophylactic treatment with Co-trimoxazole — an antibiotic recommended by WHO for all such patients to protect them against opportunistic infections like pneumonia. The patient will then be referred to the closest anti-retroviral (ART) centre for treatment.

According to Dr Rahul Thakur, Naco’s national consultant for TB/HIV, this intensified TB/HIV services package will first be rolled out in nine states with high prevalence of both HIV and TB cases by October 1. They include Manipur, Nagaland, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Meghalaya, Pondicherry and Goa.

“Selective testing for HIV will continue on those diagnosed with TB if they are found to have a high risk behaviour and are suffering from sexually transmitted infections. However, in the nine states, all TB patients, irrespective of their lifestyle, will be offered free HIV testing. We believe 50,000-80,000 people suffer from HIV/TB co-infection in India. In 2007-2008, we managed to locate 40,000 of them, as against just 9,000 the previous year,” Dr Thakur said. He added that India plans to add 800 more ICTCs by the end of 2008.

Dr Neeraj Raizada, WHO’s consultant at the central TB division, said of all known TB patients, 1.2% were presently HIV positive. “Like ICTCs, which test for HIV, India’s Revised National TB Control Programme (RNTCP) has 12,000 designated microscopy centres (DMC). Each of these DMCs are established for every one lakh population.

HIV and TB testing facilities in all these nine states are decentralised and near to each other. So as soon as a person is diagnosed with TB, we will offer him voluntary HIV testing. If found positive, he will be counselled, put on prophylactic treatment and sent to the nearest ART centre on priority basis,” Dr Raizada said.

Dr Thakur said that once a person was identified with co-infection, he/she would be kept track of, to ensure they were following the proper treatment regimen. Of the 2.5 million HIV infected Indians, over 10% are expected to have full blown AIDS. Every AIDS patient has 15% chance every year of developing TB. Widespread stigma around TB and HIV/AIDS also prevents many people living with either or both diseases from seeking treatment.

Officials said TB had re-emerged with a vengeance that could reverse a decade of advances in the fight against HIV/AIDS. The deadly combination was fuelling a TB resurgence globally. There are 14 million people co-infected with TB-HIV in the world.

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