90-90-90 HIV targets: implications for HIV-associated tuberculosis

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• The syndemic of HIV and Mycobacterium tuberculosis (TB) presents a significant global health challenge.
• Global targets for HIV and TB control have been established, emphasizing the need for integrated disease management.
• Effective control requires a coordinated approach to policy, economic investment, and public health strategies for both diseases.

Purpose of the Study:

• To explore current policies, economic investments, and disease control strategies for HIV, TB, and HIV-associated TB.
• To review published data on HIV, TB, and HIV-associated TB in 30 WHO priority countries.
• To propose a comprehensive care continuum for managing HIV and TB co-infection.

Main Methods:

• Review of published data on HIV, TB, and HIV-associated TB.
• Analysis of policy and economic investment strategies.
• Development of a proposed integrated care continuum model.

Main Results:

• Significant variability in antiretroviral treatment (ART) coverage (13-84%) and viral suppression (21-79%) among people living with HIV (PLHIV) in 2016.
• Low uptake of isoniazid preventive therapy (IPT) (5%) among PLHIV without TB.
• TB treatment success rates varied widely (34-94% in 2015), with a lack of combined indicator data.
• Average annual global funding for TB and HIV-associated TB (2003-2017) was $2.9 billion.

Conclusions:

• Integrating HIV and TB control efforts, including monitoring and evaluation, is crucial for disease elimination.
• A comprehensive HIV and TB care continuum supports integrated disease management for improved individual and public health outcomes.
• Enhanced policy, investment, and combined disease control strategies are essential to meet global HIV and TB targets.