E-drug: Antiretrovirals in developing countries (cont'd)
---------------------------------------------
Another perspective vis a vis antivirals in developing countries and TB.
I am sure each country has a different experience vis a vis TB and HIV
co-infection. From looking at what is happening at MGH in India and
the public hospitals in Malawi, I would infer that TB is actually an
opportunistic infection associated with HIV. I note that in India where
there are several thousand people in private clinics taking triple drug
(American style) cocktail therapy who had TB as a co-infection, TB
went into remission as soon as HIV infection was underway--it may be
that much of the TB epidemic is actually HIV relative in a dynamic
fashion. The Health Ministry of Malawi has data strongly suggesting
that HIV is the cause of the TB epidemic and that treatment of HIV
may be what is adequate to achieve control of TB which, for most
people who are pos for TB is immunologically controlled. In part this
stems from their TB experience in which by 1982 they had closed 3/4
TB wards due to nearly completely successful control of TB until the
HIV epidemic brought it roaring back. I believe we ought to do a
meaningful trial to see if treating patients with TB co infected with
HIV for HIV eliminates the need for therapy for TB, or reduces its time
etc.
Anyway, anyone who is interested in this question from either the
perspective of doctors in Bombay or in Malawi might contact in
Malawi, Dr. Wilfred Nkhoma (Malawi's Ministry of Health and
Population, c/o MANET@malawi.net or call 265 740 423 or in India,
Dr. Shashank Joshi, at srjoshi@vsnl.com
David Scondras
Search for a Cure
Boston, MA
617 266 0735
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.