Maha starts 1HP to prevent TB in people living with HIV
Tuberculosis is an infectious disease caused by the bacterium Mycobacterium Tuberculosis. It can cause infection in the lungs or other tissues
In a significant change in the Tuberculosis Preventive Treatment (TPT) for people living with HIV (PLHIV), Maharashtra has started a new drug regime of 1HP for TPT which has reduced the duration of medication from six months to just 28 days, officials said.
Tuberculosis is an infectious disease caused by the bacterium Mycobacterium Tuberculosis. It can cause infection in the lungs or other tissues. It commonly affects the lungs but it can also affect other organs like the spine, brain or kidneys. People with compromised immune systems such as PLHIV, diabetics and the malnourished are at a much higher risk of Tuberculosis (TB) infection. Tuberculosis remains the leading cause of death among PLHIV.
Since 2016, PLHIV have been administered Isoniazid doses for six months (180 doses) as part of the TPT. In settings with high HIV and TB prevalence, a greater number of doses have been administered. Since last month however, the new drug regime of 1HP has been started in Maharashtra. Now, PLHIV are administered 28 doses of Rifapentine and Isoniazid (combination drug) instead of 180 doses of Isoniazid under the National Tuberculosis Elimination Programme (NTEP), officials said.
Dr Aniruddha Kadu, World Health Organisation (WHO) consultant to the Maharashtra TB programme, informed that all PLHIV visiting Anti-Retroviral Therapy (ART) centres and Integrated Counselling and Testing Centres (ICTCs) with any of the four symptoms of cough, fever, night sweat, and weight loss are tested for TB. “If they test positive, they are put on TB treatment and if they test negative, they are put on TPT. This short regime of 1HP will definitely increase the adherence amongst the vulnerable population of PLHIV,” he said.
The government has a single-window facility for PLHIV for both HIV and TB treatment. The TPT and HIV treatment is available at all ART centres in the state. There is no need for multiple visits, and both ART centres and ICTCs are linked to the testing centres.
Dr Sandeep Sangale, joint director (TB and Leprosy), Maharashtra, informed that directions have been issued to all ART centres to immediately start the 1HP drug regime for TPT in PLHIV. “These people are vulnerable to TB infection, which is the leading cause behind morbidity and mortality in PLHIV. People don’t die due to HIV. However, PLHIV are reportedly found to die after contracting TB infection due to delayed or no treatment,” he said.
Dr Sangale further informed that new advancements have helped in early identification and treatment of TB patients. “PLHIV can prevent morbidity and mortality by getting early tests and treatment. All facilities are given free-of-cost, which should be availed by the patients,” he added.
