Tuberculosis in HIV infected patients - Essay Example

This paper shall discuss tuberculosis among HIV patients, including its management, and expected patient outcomes. Discussion According to the US Centers for Disease Control and Prevention, TB is the leading cause of death among HIV patients with almost one in four deaths attributed to tuberculosis. Statistics also indicate that about 20% of patients with TB and HIV have died in 2007; and individuals with HIV and TB account for 32% of patients having died during TB treatment (CDC). These figures indicate the impact of the TB on the HIV patient, how it exacerbates the patient’s condition and even places him at a significant and mortal risk.

There are significant challenges which health professionals face with the treatment of TB among HIV patients. It is also important to note that multi-drug resistant tuberculosis (MDR-TB) can manifest among HIV patients. This is unfortunate because these patients would often manifest resistance to two of the best anti-TB drugs – isoniazid and rifampicin (CDC). This type of TB is very difficult to treat and is sometimes a death sentence for HIV patients. Experts suggest that in order to control the occurrence of MDR-TB, the treatment has to be improved not just in the US, but all over the world.

The most effective treatment for TB is still the DOTS treatment or the directly-observed therapy; and in order to improve the treatment of MDR-TB, the application of the DOTS must be expanded (CDC). The treatment of TB among HIV patients is more or less similar to the treatment of adult TB patients without HIV. However, managing this disease among HIV patients is complicated; moreover, these patients must also seek care from health professionals with expertise in managing HIV patients with TB (CDC).

Since HIV patients are usually already taking in numerous medications, it is important for health experts to note which drugs would have negative interactions with each other, so as not to further exacerbate the patient’s condition. These experts are also focusing their health programs towards preventing the spread of this disease among the non-HIV population, and more particularly among the HIV population (CDC). Various methods for the management of TB among HIV patients have been suggested.

In a paper by Madhi, et.al., (p. 21) the authors sought to evaluate the use of isoniazid prophylaxis against TB among HIV infected children and uninfected children exposed to HIV during the their prenatal period. The authors considered about 540 HIV infected and 804 uninfected infants, assigning them to the isoniazid or the placebo group for 96 weeks. The respondents were assessed on tuberculosis disease, death among HIV-infected children and latent TB infection (Madhi, et.al., p. 21). The study established that the use of primary isoniazid prophylaxis among HIV-infected children and uninfected children did not improve their TB-disease free survival.

In effect, even with the application of antiretroviral therapy, TB among HIV infected children remained high (Madhi, et.al., p. 21). There is a need to review the available treatment methods for these children, in order to establish appropriate preventative measures on the occurrence of TB. Martinson’s paper below provides an alternative to the isoniazid treatment. Martinson (p. 11) sought to evaluate the use of three new regimens for latent TB which may be more effective than the standard isoniazid treatment.

The authors assigned respondents with HIV and TB and who were not