The Best Time to Start Treating HIV in People with TB
Severely immunocompromised patients who are infected with both HIV and tuberculosis (TB) and who have never been treated for HIV should start therapy for the virus as soon as possible after beginning TB treatment, according to two newly published papers in the New England Journal of Medicine.
With NIAID support, the studies addressed the dilemma that starting treatment for HIV before a patient’s TB disease is under control can lead to severe illness or death from immune reconstitution inflammatory syndrome (IRIS), but starting HIV treatment too late may allow the patient to die from HIV infection. The studies found that even though IRIS occurred more often in patients who were treated for HIV early, more of the sickest patients receiving early HIV treatment survived compared to those who started treatment later.
TB is the leading cause of death for people with HIV, accounting for 400,000 HIV-related deaths worldwide in 2009 alone.
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