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Posts Tagged ‘Gavin Churchyard’

Note: From July 19-22, the Center for Global Health Policy’s staff will be live blogging from the International AIDS Society 2009 meeting in Cape Town. This post was written by Center director Christine Lubinski, who attended a two-day pre-meeting on HIV/TB co-infection.

Despite the scope and gravity of HIV/TB confection, there are glimmers of hope from the field—new diagnostics, a better vaccine, and a host of other innovations were the subject of a two-day session in Cape Town, “Catalyzing HIV/TB Research: innovation, funding, and networking,” which served as a prelude to the 2009 IAS meeting. The backdrop provided a fitting reminder of the urgency of this health crisis; South Africa is the epicenter of the co-infection epidemic, with one quarter of the world’s cases of HIV/TB co-infection.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, headlined the meeting, organized by the World Health Organization, the International AIDS Society, the Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE), and other groups. Calling the most commonly used diagnostics for TB “ridiculous,” Fauci noted that it was “tragic and shameful” that generations of research advances had “bypassed TB research.”  As he did at the Pacific Health Summit on MDR-TB in June, Fauci called for a transformative research response to TB and by extension, HIV/TB co-infection.

Dr. Fauci’s address was followed by a series of presentations that both highlighted the enormity of the problem and its associated morbidity and mortality, but also framed the potential that further research and more widespread implementation of interventions hold. 

Dr. Robin Wood, from the Desmond Tutu HIV Research Center at the University of Cape Town, focused on the impact of ART on TB prevention. Dr. Wood reported that 67 percent of persons presenting for ART in their clinics have TB or have had TB. Analyzing the impact of ART on a high HIV prevalence township community, researchers found a 77 percent reduction in HIV/TB co-infection during the 5-year ARV rollout period.  Wood noted while there is widespread speculation about the impact of community-wide ART penetration on HIV incidence, there is little doubt that small changes in HIV prevalence produce dramatic changes in TB incidence.  The earlier ART is started, the greater the impact on TB, given the increased vulnerability to TB as HIV disease progresses. (more…)

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