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The article discussed the relationship that exists between HIV-infected people and tuberculosis (TB). The article indicates that there exists a biological synergy between HIV and TB. HIV infection lowers the immunity of a person that makes the person become more vulnerable to TB infection. In the U.S., more than 60% of TB cases originate from foreigners who suffer from latent TB infections before migrating to the United States. In 2010, about 8% of active TB cases happened to patients who suffered from HIV. TB infection remains an important aspect of HIV clinicians in the United States of America. However, the United States of America has recorded a great decline in TB infections in the last decade. The article indicated a decrease of approximately 3% of TB infections in 2010. The clinician put a lot of emphasis on TB because the disease is highly infectious, as well as difficult to diagnose. Moreover, TB is a sensitive illness because the improper medication is dangerous as it can result in the illness becoming resistant to drugs to both the patient and the person to who the patient transmits the infection. Even though there are other factors that increase the risks of TB infection, such as diabetes, malnutrition, immunosuppressive drugs, HIV infection remains the prime factor in TB infection.
What the article is about
TB is an illness caused by the Mycobacterium tuberculosis complex, which are organisms that grow gradually and only recognized with special staining techniques. TB mainly attacks the lungs causing chronic pneumonia. However, TB can also affect other body organs such as bones, liver, and spleen. Transmission of TB occurs when healthy persons come- in contact with the sputum of TB patients who suffer from active TB. Patients with positive-smear sputum are highly infectious. In most individuals, the initial TB infection is controllable by an effective immune response. However, in many cases, the infection leads to latent TB, which may turn reactive and result in active TB later in life. TB infection occurs in two phases. The first infection attacks the lungs and is mainly controllable by the immune system. However, before the immune system makes it inert, it spreads to other organs such as lymph and bones. Then, the immune system contains it from spreading further. It remains in that start until the individual gets a further infection when it reactivates into active TB.
Those people who suffer from HIV are more likely to develop active TB after the initial TB infection because of their immunosuppressant. Primary progressive TB cause chronic pulmonary disease and can cause meningitis. Those individuals who suffer from latent TB and develop immunodeficiency because of HIV-infection are at a high risk of developing active TB (Ahuja, King & Munsiff, 2012).
Claims about Treatment
The article gives important claims about the treatment of TB. For instance, the article posits that TB treatment should commence once a proper specimen that guarantees the identification of TB infection has been established. A person who suspects suffering from TB should take a smear TB test. The doctors should confirm the smear results through NAA testing before commencing medication. The article notes that ART decreases mortality in HIV-infected individuals having active TB, irrespective of the number of initial CD4 cell count. This calls for effective ART initiation for anyone with TB/HIV co-infection. Once the treatment of TB starts, adherence to the treatment is fundamental for the successful treatment of TB.
TB patients should seek treatment mainly in public health institutions where there is patients’ enhancement to adherence to medication through Direct Observed Therapy (DOT), where every dose taken by the patient is documentable. The documentation is important in enhancing adherence, as well as decreasing the mortality rate of HIV-infected TB patients. The TB patients who suffer from HIV are encouraged to visit government medical institution in order for the HIV clinicians to coordinate their HIV management accordingly with the health department. This is imperative for the proper management of HIV patients to avoid drug reactivity (Dean, Edwards, Ives, 2000; Narita Ashkin, Hollender, 1998).
The article was very important in educating about how TB occurs. TB infection occurs in two phases. The initial infection occurs when an individual suffers from TB when he/she come into contact with the sputum of a patient suffering from active TB. In most cases, the infection is containable by the immunity system. However, this is not the case for those people who suffer from HIV-infection, as they suffer immune-suppression. Therefore, when HIV-infected people come in-contact with TB, causing organisms from the sputum of TB patients, after the initial infection, the TB infection progresses to active TB. The article highlighted the importance of starting TB medication after properly diagnosing the presence of TB specimens through NAA testing. Once the medication commences, the patient should ensure adherence to medication to avoid TB becoming resistant to drugs. TB patients are encouraged to seek medication from government hospitals. Seeking TB medications from government health care facilities is important in making sure that there is appropriate coordination between HIV clinicians and health care to enhance the HIV management process.
Ahuja, S, King, L & Munsiff, S. (2012). TB and HIV Coinfection: Current Trends, Diagnosis and Treatment Update. Web.
Dean GL, Edwards SG, Ives NJ. (2000).Treatment of tuberculosis in HIV-infected persons in the era of highly active antiretroviral therapy. AIDS.16, 5, 75-83.
Narita M, Ashkin D, Hollender ES. (1998).Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS. Am J Respir Crit Care Med. 158, 45,157-161.