Integrating health services for the better management of South Africa’s terrible twins: Aids and TB

Abstract

HIV is the most powerful risk factor for reactivation of latent TB infection to active disease. This latent infection is found in over 90% of South Africans, a nation that also hosts the largest number of people living with HIV in the world. HIV also increases the rate of new and recurrent TB infections by attacking the immune system thereby increasing the lifetime risk of getting sick with TB after infection from about 10% to 50%. The result is an environment full of challenges to the health professionals tasked with the control of the dual epidemic and with the clinical management of the two diseases. Success in managing this dual epidemic requires a commitment to the integrated management of HIV and TB and the full involvement of community members to encourage involvement of civic society and Non Government Organisations in shaping the HIV and TB agenda.