Study Recommends TB Treatment for AIDS-Infected Addicts
Drug abusers who are infected with the AIDS virus and tuberculosis bacteria should be treated with medicine to prevent full-blown TB, says a study published today. Doctors have noticed a growing prevalence of tuberculosis in recent years among people at high risk of AIDS, especially drug addicts. In the study published in the New England Journal of Medicine, the TB usually resulted from activation of lingering tuberculosis infections, not new exposures to the bacteria, in people who also are infected with the AIDS virus. The doctors warned that besides being at risk of getting tuberculosis themselves, AIDS-infected addicts who carry the TB bacteria also may pass the germs to people they live with, to health care workers and other people. ``The aggressive identification and treatment of HIV-infected intravenous drug users with latent tuberculous infection is therefore of both clinical and public health importance,'' wrote Dr. Peter A. Selwyn of Montefiore Medical Center in New York. People may carry either the AIDS virus or tuberculosis bacteria for many years without getting sick. While most people with the AIDS virus eventually go on to get acquired immune deficiency syndrome, people who carry the tuberculosis bacteria ordinarily have only about a 10 percent life-long risk of getting TB. HIV _ the AIDS viurus _ weakens the body's defenses against disease. The study suggests that it lowers resistance to the tuberculosis bacteria, putting people at much higher risk of TB. The study was conducted on 520 drug users who were in a methadone program. When the study began, 42 percent already were infected with HIV. Twenty-three percent of those with HIV also carried TB bacteria as did 20 percent of those who were free of the AIDS virus. During almost two years of followup, active tuberculosis developed in eight of the AIDS-infected people, but in none of those who did not have HIV. Seven of the eight TB cases occurred in people who were already infected with tuberculosis bacteria before the study began. The doctors noted that 13 people who carried HIV and TB bacteria were treated with the drug isoniazid, and none of them went on to get active tuberculosis. However, seven of 36 people with both infections who did not take the medicine got TB. The doctors said that the drug is now administered along with daily methadone doses at the clinic where the study was conducted.
medicine;tuberculosis bacteria;tuberculosis infections;aids virus;drug abusers;drug addicts