Preventing, Detecting and Treating Critical Co-Infections
What Works
Tuberculosis
- Initiating HIV treatment before or during TB therapy can reduce the incidence of TB and increase patient survival for those living with HIV, including for patients with XDR TB.
- Isoniazid preventative therapy can reduce the incidence of active TB and increase survival among people living with HIV.
- Active case finding increases TB detection, particularly in sub-Saharan Africa where HIV is driving the epidemic.
- Routine screening and treatment of TB and HIV patients in endemic countries can increase detection of co-infection and increase patient survival.
- Provider-initiated HIV testing and counseling can be acceptable, feasible and lead to high uptake of HIV testing among TB patients.
There are promising strategies and further discussion that you can read about by clicking on the button below.
Malaria
- Co-trimoxazole prophylaxis, antiretroviral therapy and ITNs can substantially reduce the incidence of malaria in women living with HIV.
- Intermittent preventive treatment of malaria with sulfadoxine-pyrimethamine (SP) is effective in preventing malaria and decreasing prevalence of anemia among pregnant women with HIV.
There are promising strategies and further discussion that you can read about by clicking on the button below.
Hepatitis
There are currently no strategies for Hepatitis that have been classified as "What Works".
There are promising strategies and further discussion that you can read about by clicking on the button below.
Certain infections can be significantly more severe and lead to early death for people living with HIV. Tuberculosis (TB) has become the leading cause of death for those living with HIV. Malaria can have serious impacts on pregnant women. Co-infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), if untreated, increases the risk of non-liver and liver-related illness and death in people living with HIV. A systematic review of 18 studies found that treating co-infections such as TB, malaria, helminthes and STIs reduced viral load, even among populations that were entirely or predominantly ART naïve (Modjarrad and Vermund, 2010). Tuberculosis, malaria and hepatitis, when present as co-infections with HIV, warrant further discussion regarding their prevention, detection and treatment. Sexually transmitted infections are discussed in Treating Sexually Transmitted Infections (STIs) and in Meeting the Sexual and Reproductive Health Needs of Women Living With HIV. Helminth infections are outside the scope of this review.[1]
[1] As noted in Methodology, the sections on malaria and hepatitis, were not as thoroughly reviewed as other topics in the compendium. Consultation with co-infection experts should complement the information in these sections. Some references to groups working on co-infections are provided.