Welcome News In the Fight Against MDR-TB and HIV

Dr. Evan LeeToday's guest blog comes from Lilly's Vice President of Global Health Programs and Access, Dr. Evan Lee.

An encouraging new study covered by the New York Times today offers evidence that people living with the double-burden of multidrug-resistant TB (MDR-TB) and HIV/AIDS can be treated successfully for both conditions.

The data, published this month in the International Journal of Tuberculosis and Lung Disease, found that in a group of South African patients infected with MDR-TB and HIV, the mortality rate was 86 percent lower for patients that started treatment for both diseases simultaneously versus those that were treated sequentially (i.e. who started HIV treatment only after completing MDR-TB treatment).

While the sample size is small, the findings are statistically significant and very promising for global health. As I noted on World AIDS Day last year, we simply cannot win the fight against TB or HIV/AIDS without addressing their devastating interaction in patients. In 2012, 1.1 million people worldwide were co-infected with TB and HIV, and 320,000 people with HIV died from TB.

Significant progress has been made in recent years to combine TB and HIV treatment strategies. More than half of TB patients living with HIV in 2012 began antiretroviral treatment, according to the World Health Organization. But as the study authors point out, we still don’t have a firm understanding of the extent to which antiretroviral treatment impacts patients with both HIV and MDR-TB. The data from South Africa is therefore a welcome new piece of the puzzle.

On its face, the study results suggest that we may be able to prevent extensive loss of life among patients co-infected with MDR-TB and HIV by tweaking current treatment regimens in national health care programs and large-scale initiatives to address TB-HIV co-infection through the US President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, TB and Malaria (both of which provided support for the study).

Further research to confirm these results should be conducted most urgently. In South Africa alone, approximately six million people are living with HIV, and as the Lancet recently documented, drug-resistant TB continues to spread throughout communities across the region.