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Every HIV-TB patient will now undergo MDR-TB tests

State officials have found a one-size-fits-all formula for curbing the TB epidemic.

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Faced with the twin challenges of curbing the rising number of multi-drug resistant tuberculosis (MDR-TB) and high mortality rates in patients with HIV-TB co-infection, the state officials have found a one-size-fits-all formula for curbing the TB epidemic.

The formula is simple — nip the problem in the bud through early detection.

State joint director for tuberculosis and leprosy Dr Pradeep Gaikwad said, “Guidelines have been revised to tackle late detection of MDR-TB. Until now, we first tried basic course treatment for HIV-TB person and, if it didn’t work, we tested for MDR-TB to start advanced drug regimen. But from now on, every HIV-TB patient will undergo MDR-TB tests.”

He said that about 17% of HIV-TB co-infection cases tested positive for MDR-TB.

“Earlier six months were lost as MDR-TB wasn’t suspected until first line drugs failed. But now we are eliminating that time gap in detection. Now all HIV-TB patients would be started on anti-retroviral treatment (ART) irrespective of CD4 counts (a type of white blood cell that fights infection and their count indicates the stage of HIV or AIDS in a patient). Earlier only patients with low CD4 counts were started on ART but now early treatment would bring down mortality rate,” Gaikwad said.

In January, after scare of total drug resistant TB (TDR-TB) struck Mumbai, it was classified a Category C city. The criteria are now being extended to entire Maharashtra and complete implementation is expected by December 2012, said Gaikwad.

“We carry out basic sputum test to determine TB. However, results are not entirely reliable. If a patient comes for re-treatment after taking incomplete treatment for few months, it could be that the bacteria have become suppressed. However, on culture tests, it shows they have MDR-TB. Hence, we have revised criteria and all re-treatment cases to undergo advanced tests,” he said.

Sassoon General Hospital head (TB department) Dr S Gaikwad said the modification will help bring down the mortality rate in HIV patients.

PD Hinduja Hospital chest physician Dr Ashok Mahasur said, “HIV positive patients are extremely vulnerable to TB and pneumonia as the virus affects a patient’s immune system. It will help in saving lives of HIV-TB co-infected patients.”

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