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La epidemia de tuberculosis asociada al VIH, ¿cuándo actuaremos?
Anthony D Harries1, Rony Zachariah, Elizabeth L Corbett
1International Union Against Tuberculosis and Lung Disease, Paris, France. adharries@theunion.org
Lancet (London, England)
|May 22, 2010
Resumen
El diagnóstico y el tratamiento agresivos de la infección por VIH, junto con la política de 3Is y el tratamiento antirretroviral previo (TARV), pueden reducir significativamente la incidencia de tuberculosis en individuos VIH positivos. Este enfoque integrado es crucial para controlar la epidemia de tuberculosis asociada al VIH.
Área de la Ciencia:
- Salud Pública La salud pública.
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
Sus antecedentes:
- La epidemia de tuberculosis asociada al VIH sigue siendo un desafío crítico para la salud mundial, particularmente en el África subsahariana.
- La prevención de la tuberculosis en personas que viven con el VIH (PLWHIV) es un área descuidada que requiere atención urgente.
Objetivo del estudio:
- Abogar por una estrategia más agresiva para el diagnóstico y tratamiento temprano del VIH para frenar la incidencia de la tuberculosis.
- Hacer hincapié en la importancia de integrar la atención del VIH con las estrategias de control de la tuberculosis.
Principales métodos:
- Proponer pruebas frecuentes de VIH y el inicio temprano del tratamiento antirretroviral (TARV).
- Recomendando la implementación de la política de 3Is (descubrimiento intensificado de casos de tuberculosis, control de infecciones y terapia preventiva con isoniazida).
- Destacando la necesidad de paquetes integrales de atención del VIH, incluida la profilaxis con co-trimoxazol y el TARV, para el PLWHIV con tuberculosis.
Principales resultados:
- Se espera que el diagnóstico precoz del VIH y el tratamiento antirretroviral conduzcan a la reconstitución inmune individual y a una reducción de la transmisión del VIH, disminuyendo así la incidencia de la tuberculosis.
- La combinación de la política de 3Is con la iniciación temprana de ART puede reducir la carga de la tuberculosis en PLWHIV y crear un entorno más seguro para la administración de ART.
Conclusiones:
- Un enfoque integrado que combine el diagnóstico y tratamiento temprano del VIH, la política de 3Is y la atención integral del VIH con la terapia de corta duración (DOTS) para la tuberculosis es esencial para la prevención y el control.
- Hay una necesidad de programas de VIH y tuberculosis para implementar estrategias probadas y explorar enfoques innovadores para combatir la epidemia de tuberculosis asociada al VIH.
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