HIV, tuberculosis should be treated together-study

By Gene Emery

BOSTON (Reuters) - Treating tuberculosis and the AIDS virus simultaneously saves more than twice as many lives compared with attacking TB first, researchers reported on Wednesday.

Dual treatment pays off with a 56 percent reduction in deaths from all causes, the large South African study published in the New England Journal of Medicine showed.

About 33 million people worldwide are infected with HIV, the AIDS virus, and 9.2 million have recently been diagnosed with lung-destroying tuberculosis, according to the World Health Organization.

In many cases, HIV's suppression of the immune system allows the deadly tuberculosis bacterium to thrive. In South Africa, about 73 percent of TB patients also have HIV.

Yet doctors have been reluctant to treat both at once, often choosing to go after TB first. They have been concerned about drug interactions, overlapping side effects and the large number of pills that patients have to take each day.

"You add to the risk of side effects very substantially," Dr. Salim Abdool Karim of the University of KwaZulu-Natal, in Durban, South Africa, said in a telephone interview.

Treating TB requires months of antibiotics. HIV is incurable and patients must take cocktails of antiviral drugs for life.

"What you don't want is patients stopping the TB drugs," Karim said. "So most doctors treating a patient with TB and HIV prefer to finish with the TB drugs and then start on the antiretroviral drugs."