Tuberculosis is the main cause of death among people with HIV and AIDS worldwide, killing about 400,000 people every year. But how to best treat both conditions has been unclear, because of worries about how the drugs will interact and the burden that dual treatment puts on patients, who must take dozens of pills every day with some grueling side effects.
The study, published Wednesday in the New England Journal of Medicine, found that patients whose immune systems have been most damaged by HIV benefited by beginning antiretroviral drugs two weeks after starting TB treatment, instead of waiting eight to 12 weeks, as is commonly done now. Those patients were 40 percent less likely to die or develop AIDS.
Later in the article, Stanford's Andrew Zolopa, MD, notes that the clinical approach to TB and HIV has been to "'get the active infection under control and worry about HIV later,' and that's the wrong answer." But this study and two others appearing in the journal, Allday writes, "make it clear that patients are better off aggressively treating their HIV infection soon after starting TB therapy."