Treating TB, HIV co-infections early, aggressively can save lives, multiple studies show

"Treating tuberculosis (TB) and HIV infections at the same time can be a challenge for patients and their doctors, but attacking both diseases early and aggressively isn't harmful and could save the lives of those who are sickest," according to a global study led by researchers from the University of California, San Francisco (UCSF) and published Wednesday in the New England Journal of Medicine (NEJM), the San Francisco Chronicle reports. The study found that patients whose immune systems have been most damaged by HIV were 40 percent less likely to die or develop AIDS if they began antiretroviral treatment (ART) "two weeks after starting TB treatment, instead of waiting eight to 12 weeks, as is commonly done now," the newspaper writes.

"The UCSF study, along with two similar studies" -- one by researchers at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and another by researchers of the CAMELIA (Cambodian Early versus Late Introduction of Antiretrovirals) study team -- "also published in the New England Journal of Medicine on Wednesday, makes it clear that patients are better off aggressively treating their HIV infection soon after starting TB therapy," the Chronicle notes (Allday, 10/20). An editorial accompanying the studies concludes that "the evidence, including the study results presented in this issue of the Journal, provides support for the earlier initiation of ART in patients co-infected with HIV and tuberculosis who have advanced immunosuppression, apart from those who present with tuberculous meningitis" (Torok/Farrar, 10/20).