The prevalence of HIV positivity among Tuberculosis (TB) patients in Karnataka is the third highest in the country after Maharashtra and Andhra Pradesh, according to data from National AIDS Control Programme (NACP) outlined in the India TB Report 2023.
Of the total 37,578 patients diagnosed with TB-HIV co-infection in the country in 2022, Maharashtra has the highest at 5,054. Andhra Pradesh and Karnataka follow with 4,288 and 3,979 co-infected patients respectively.
The management of these cases is being jointly monitored by the National TB Elimination Programme (NTEP) and NACP field staff. The TB treatment success rate for TB-HIV co-infected cases is 75%, stated the report.
Ansar Ahmed, State Joint Director (KSAPS), who is also the Deputy Director (TB), said 94% of 80,558 TB patients diagnosed in 2022 in Karnataka have a known HIV status. “TB death rate in Karnataka now stands at 6.6%. The high prevalence of TB-HIV co-infection is one of the reasons for the high death rate,” Dr. Ahmed said.
Screening in prisons
Inmates of all prison settings and other closed settings, including juvenile homes, were also subjected to TB screening, referred for testing and linked to treatment as per the programme guidelines. The NACP and NTEP programme follow the patients for treatment adherence post release by the district-level field staff.
According to the India TB Report 2023, TB screening in prisons has been undertaken in 1,262 prisons across the country by the NACP in 2022. While 74% of the prison inmates (84,619 out of 11,33,483) were screened for TB, about 81% of the diagnosed TB cases (980 out of 1,209) have been put on treatment.
In Karnataka, 52 prisons were covered under NACP and 33,102 of the 36,601 inmates were screened. Of these, 369 were referred for testing and 283 were tested for TB and 12 tested positive.
Post COVID-19
Parveen, a PLHIV community leader said while HIV infection numbers are reducing, the number of Drug Resistant TB cases among people living with HIV who are co-infected with TB are causing concern. “Especially after COVID-19, many of our community members have developed resistance and the diagnosis is late,” she said.
B. David, a campaigner for access to TB medicine, said the implementation of existing drug regimens is not very efficient which is the root cause of drug resistance. “More efforts are needed in this area. For the community at large, it is important to make sure of adherence so that HIV-TB coinfection is brought under control,” he said.
Ishwar Gilada, former president of AIDS Society of India, said a national joint programme should be chalked out to handle TB-HIV co-infections. ”Currently, both are vertical programmes. The National HIV program has a lot to learn from the National TB program, especially the rollout of public-private partnership (PPP), which is very effective. We have written to the Prime Minister and already had a discussion with Union Health Minister Mansukh Mandaviya on integration of HIV and TB programmes,” Dr. Gilada said.
