title: Providing HIV care for tuberculosis patients in sub-Saharan Africa.
abstract: Human immunodeficiency virus (HIV)/acquired immunedeficiency syndrome (AIDS) and tuberculosis (TB) cause an immense burden of disease in sub-Saharan Africa. A large amount of knowledge has been gathered in the last 15 years about the negative impact that HIV has on TB control, both at a programme level and at the level of the individual patient. Equally, interventions that are known to benefit patients have been tested and piloted, and these form important components of international TB-HIV guidelines, a TB-HIV strategic framework and an interim policy on TB-HIV coordination. Unfortunately, in sub-Saharan Africa there is little evidence that these interventions are being implemented on the ground, and one of the reasons for this paralysis is that the operational details are not well developed. This paper takes the three important HIV interventions of HIV testing and counselling, cotrimoxazole preventive treatment and antiretroviral treatment, and discusses some of the practical details of on-the-ground implementation. We hope that this will generate discussion, but above all, the impetus to start delivering services to patients.
authors.affiliation: HIV Unit, Ministry of Health, Lilongwe, Malawi. adharries@malawi.net
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.forename: M
authors.initials: M
authors.lastname: Boxshall
authors.forename: S
authors.initials: S
authors.lastname: Phiri
authors.forename: J
authors.initials: J
authors.lastname: van Gorkom
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.forename: S B
authors.initials: SB
authors.lastname: Squire
authors.forename: S D
authors.initials: SD
authors.lastname: Makombe
authors.forename: J
authors.initials: J
authors.lastname: Kwanjana
authors.forename: M
authors.initials: M
authors.lastname: Gondwett
mesh_terms: D017954:Africa South of the Sahara; D000998:Antiviral Agents / Q000627:therapeutic use; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy*
chemical_list: D000998:Antiviral Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination