Time to act on the evil duo: treat tb, manage hiv and save lives

TB and HIV have been closely linked since the emergence of AIDS. This review paper aims to explore the double burden of TB-HIV worldwide, social impact of the epidemic, strategies being followed to control the epidemic and the challenges associated with TB-HIV control activities. An estimated one-third of the 40 million people living with HIV/AIDS (PLHIVs) worldwide are co-infected with TB. PLHIVs are also evaluated to be 15 times more likely to develop TB than HIV negative people. These two diseases represent a lethal combination since they are more destructive together and project challenges in both diagnosis and treatment, interactions between HIV and TB medications, and overlapping medication toxicities, Immune Reconstitution Inflammatory Syndrome (IRIS) and challenges related to adherence. As the HIV and TB services seem disconnected at present, they result in an increase in the cost of care for patients, higher losses to follow-up due to depression and stigma and delays in ART initiation. To combat the fuelling epidemic of HIV and TB globally, there is a need for a Zero parallel system for HIV and TB that must create coherence and synergy between the two programs and strengthen the mechanisms that would indicate effective control, interventions to improve quality of life and significant public health gains. There is a potential need to improve TB treatment outcomes and the contribution that TB-HIV collaboration can make. It also demands additional research to reduce spread of TB, pro-actively identify TB in PLHIVs and reduce mortality.