For patients with both HIV and tuberculosis the timing of drug therapies is critical
In sub-Saharan Africa, tuberculosis is the disease that most often brings people with HIV into the clinic for treatment. Infection with both diseases is so common that in South Africa, for instance, 70% of tuberculosis patients are HIV positive. How best to treat these doubly infected patients-- who number around 700,000 globally-- is the subject of a new study, published in The New England Journal of Medicine, by scientists at Columbia University's Mailman School of Public Health and CAPRISA (Centre for the AIDS Programme of Research in South Africa). The authors had previously shown that integrating antiretroviral therapy (ART) concurrently with tuberculosis treatment reduces mortality among these patients and is preferable to treating the diseases sequentially. The new study investigates the best timing for introducing treatment for HIV. The researchers find that the optimal time for antiretroviral treatment depends on the patient's immune status. Patients with very low T-cell counts,...