Should tuberculosis prophylaxis be given to all HIV-infected persons in resource-limited, high-TB-incidence settings?
A July 13, 2000, debate at the XIII International AIDS Conference focused on whether tuberculosis (TB) prophylaxis should be given to all HIV-infected persons in resource-limited, high-TB-incidence settings. The argument centered on the value of tuberculin skin tests and the relative merits of early versus late intervention. TB is now the leading cause of death for HIV-infected people in many developing countries. For blanket prophylaxis Alwyn Mwinga (University Teaching Hospital, Lusaka, Zambia) presented the case for TB prophylaxis for HIV-infected people in resource-limited settings. She quoted World Health Organization (WHO) statistics estimating 10 million cases of TB worldwide in 2000, 1.4 million of which are attributed to coinfection with HIV. “HIV is the strongest risk factor for reactivation of latent TB infection,” said Mwinga. “Thus a role for prophylactic TB treatment has been suggested again in developing countries.” Izoniazid has been used to treat latent TB infection si
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