About the TB/HIV Working Group
The TB/HIV Working Group is one of the seven working groups of the Stop TB Partnership, comprising a large network of stakeholders from international organizations, donors, academia, and nongovernmental and governmental organizations from a range of different countries. It is committed to reducing the global burden of HIV related TB through effective collaboration between National TB and AIDS Control programmes and other stakeholders, and through the generation of evidence based policy and programme guidance in order to achieve the global TB/HIV targets set for 2010-2015 in the Global Plan to Stop TB. The Global Plan goal is to halve the number of deaths from TB among HIV-positive people, compared with 2004 levels.
News
Mainstreaming TB/HIV at AIDS 2012
22-27 July 2012 | Washington DC, USA
The International AIDS Society conference is one of the largest HIV stakeholder gatherings that brings together advocates, civil society, journalists, people living with HIV, policymakers, researchers, technical and funding agencies and many more. AIDS 2012, the XIX International AIDS Conference this year, will be held from 22-27 July in Washington D.C. and is expected to host some 20,000 delegates from 200 countries. This conference plays a key role in shaping the global HIV response, offering a tremendous opportunity to mainstream TB and catalyse the implementation and scale-up of collaborative TB/HIV activities. We encourage you to submit applications for TB/HIV sessions to ensure that TB remains high on the agenda throughout all areas.
Deadlines to note:
- Abstract submissions close: 15 February 2012
- Affiliated independent events applications close: 20 April 2012
- Exhibition applications close: 25 May 2012
- Global Village applications close: 15 February 2012
- Satellite applications close: 31 March 2012
- Skills building workshop applications close: 15 February 2012
For further details please visit the conference website
HIV/TB Research meeting in conjunction with the 19th conference on retroviruses and opportunistic infections (CROI 2012)
5 March, 2012 | Seattle, USA
WHO in collaboration with the Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE) and the TB/HIV Working Group of the Stop TB Partnership is organizing the 6th CROI affiliated HIV/TB research meeting which will be held on Monday 5 March 2012, 11:30-13:30 at the Grand Hyatt Seattle in Seattle, USA. The meeting will focus specifically on the measurement and reduction of TB transmission in high HIV burden settings. Despite being preventable and curable, TB is still a leading killer of people living with HIV, with nearly a quarter of all HIV deaths found to be TB-related. A third of all people living with HIV worldwide are latently infected with Mycobacteria tuberculosis (MTB), making them 21-34 times more likely to develop active TB disease than people who are HIV negative. The meeting will discuss the critical knowledge and research gaps related to MTB transmission, infection and its associated impact through sharing new data from on-going studies, discussing controversial issues and identifying critical research questions. The meeting is intended for HIV researchers, implementers and public health policy makers. Attendance of the meeting will be by invitation only and on a first come first serve basis. If you are interested in participating please send your interest to tbhiv@who.int at your earliest convenience but no later than February 15, 2012. Please see below for the provisional agenda. For the reports of research meetings from previous years please see the following link.
16th International Conference on AIDS and STIs in Africa (ICASA 2011)
4 - 8 December 2011 | Addis Ababa, Ethiopia
ICASA 2011 brought together more than 10,000 varied HIV stakeholders from 103 countries, providing an excellent opportunity to network, share experiences and learn about the successes and challenges in implementation and scale-up of TB/HIV collaborative activities. Tuberculosis was particularly well mainstreamed in this year’s conference agenda, as can be seen from the ICASA Roadmap of HIV/TB sessions and presentations. All presentations are now available at the following link.
World AIDS Day, December 2011
World AIDS Day this year is about "Getting to Zero. Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths". With almost one in four HIV related deaths attributable to TB globally and up to 50% in some settings, there is no question that TB prevention, diagnosis and treatment will contribute towards zero AIDS related deaths. Thanks to your efforts and commitment, we have observed encouraging progress in the scale-up of collaborative TB/HIV activities recently. The uptake of HIV testing and counselling for TB patients in the African and European regions has been particularly impressive. Similarly in 2010, almost 60% enrolled into HIV care were screened for TB in the African Region, and nearly one out of four eligible people enrolled in HIV care were put on Isoniazid preventive therapy. However, despite evidence based recommendations for providing ART to all TB patients, regardless of CD4 count within the first two weeks of their TB treatment, less than half of the TB patients who were identified with HIV received life saving ART. In the spirit World AIDS Day, we call upon all members of TB/HIV Working Group and friends of TB/HIV to ensure the delivery of integrated TB and HIV services including life saving ART to all people living with HIV.
Message from the Chair and Secretariat on the Occasion of World AIDS Day
For a brief overview of activities carried out by the Secretariat and the Working Group, and events planned for the coming months, please read the latest "Message from the Chair and the Secretariat" on our TB/HIV Updates page.
17th Core Group Meeting of the TB/HIV Working Group
9-11 November 2011 | Beijing, People’s Republic of China
As part of a focus on the Western Pacific region and the People’s Republic of China for 2011, the Core Group of the TB/HIV Working Group held its annual meeting in Beijing from 9-11 November. The meeting was organized by the Secretariat, based at WHO Geneva, in collaboration with the WHO office in the People’s Republic of China and the Center for Disease Control and Prevention of the People's Republic of China. Co-hosted by the Ministry of Health of the People’s Republic of China, the meeting was attended by some 90 participants, comprising Core Group members and representatives from National TB and HIV programmes in Cambodia, Papua New Guinea, the People's Republic of China and Vietnam and from six high burden provinces in the People's Republic of China. In addition, representatives from key international technical and funding agencies in the region also attended. Meeting participants reviewed progress and shared experience in regional implementation and scale-up of collaborative TB/HIV activities, and learnt about the latest tools to support scale-up as well as breaking research developments. A Chinese translation of the meeting report will be available in due course.
Agenda English, Chinese | List of Participants | Meeting Report | Presentations English, Chinese
HIV/TB Research meeting held in conjunction with the 6th conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011)
The Stop TB Department of the World Health Organization and the Secretariat of the TB/HIV Working Group of the Stop TB Partnership in collaboration with the Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE) convened a meeting in Rome on Sunday 17 July 2011, to promote high level scientific interchange of ideas and research priorities on the development of new and novel anti-TB drugs for people living with HIV with specific issues related to childhood TB and people living with HIV. Held in conjunction with the 6th conference on HIV Pathogenesis, Treatment and Prevention, the meeting shared new data from ongoing studies, discussed implementation issues and identified critical research questions. For more details on this meeting and for links to the abstracts, added to our Roadmap of HIV/TB Sessions at IAS 2011, please click on the links below:
Meeting report with presentations | Agenda | IAS 2011 HIV/TB Abstracts
Scaling-up the implementation of collaborative TB/HIV activities in the Region of the Americas
7-8 July, 2011 | Panama City, Panama
WHO, in collaboration with the Global TB/HIV Working Group of the Stop TB Partnership, CDC, USAID, UNAIDS and regional civil society representatives convened a two day regional meeting in Panama City between 7-8th July 2011 entitled "Scaling-up the implementation of collaborative TB/HIV activities in the Region of the Americas". Participants from 18 Latin American and Caribbean countries attended, comprising representatives from National Tuberculosis and AIDS Programmes and members of civil society.
The objective of the meeting was to share regional and global experiences and best practices for greater political advocacy, resource mobilization and scale-up in the implementation of collaborative TB/HIV activities and integration of TB and HIV services in the Region of the Americas. Topics discussed include HIV testing among TB patients, the Three I’s for HIV/TB and initiation of ART to reduce the burden of TB among people living with HIV, HIV-associated TB in children and vulnerable populations such as prisoners and drug users, management of MDR-TB in people living with HIV, and community involvement. For more details, please click on the links below:
Agenda (English and Spanish) | Call for Action (English and Spanish) | Presentations
Civil Society Meeting for Accelerating Advocacy on TB/HIV in the Region of the Americas
6 July, 2011 | Panama City, Panama
On 6th July WHO, in collaboration with the Global TB/HIV Working Group of the Stop TB Partnership, regional members of civil society, Treatment Action Group and UNAIDS, convened a meeting aimed at empowering civil society from 15 Latin American and Caribbean countries to advocate for increased access to collaborative TB/HIV services in the region of the Americas.
The meeting aimed to facilitate regional networking opportunities among participants and translate their experiences and concerns about TB/HIV into needs-based advocacy recommendations, as well as to help identify key TB/HIV messages to advocate for during the two day meeting "Scaling-up the implementation of collaborative TB/HIV activities in the Region of the Americas" held subsequently between 7-8 July. For further details, please click on the links below:
Agenda (English and Spanish) | Call for Action (English and Spanish) | Presentations
One million lives can be saved between now and the end of 2015 by preventing and treating Tuberculosis among people living with HIV
A publication outlining the new epidemiological model - Time to act: Save a million lives by 2015 - Prevent and treat tuberculosis among people living with HIV was launched on 6th June in New York as world leaders were convening for the UN High-Level meeting on AIDS. The new model, developed by the World Health Organization, the Stop TB Partnership and UNAIDS, shows it is possible to reduce dramatically HIV/AIDS deaths through TB prevention and treatment. In 2009 almost one in four deaths among people living with HIV were due to TB. The majority of these deaths could have been avoided as TB is both curable and preventable. The model estimates that through the scaled-up implementation of WHO-recommended collaborative TB/HIV activities, it is possible to save a million lives by the end of 2015. In 2010 a joint goal for 2015 was set by the Stop TB Partnership and UNAIDS to halve HIV related TB deaths, compared to 2004 levels. Based on the new model it has been agreed to aim to save a million lives. “Halving TB deaths in people living with HIV by 2015 is possible and is within our reach. We could save up to a million lives by 2015 and bring us one step closer to the UNAIDS vision of Zero AIDS deaths” said UNAIDS Executive Director Michel Sidibé.
The document calls for the following actions:
- Testing for HIV and TB should be provided every three years in places where both diseases are prevalent.
- Prompt TB treatment needs to be provided to every person living with HIV with active TB - or else treatment to prevent TB.
- HIV and TB treatment must be accessible and of good quality so that people living with HIV are cured of TB.
- Antiretroviral therapy (ART) should be started early, which will help prevent TB, since people living with HIV are far less likely to become ill with and die of TB if they begin ART before their immune systems begin serious decline.
- People who are HIV-positive and diagnosed with active TB should start ART regardless of the status of their immune systems.
The cost of implementing all the elements needed to achieve this is estimated to come to around $790 million a year. Dr Mario Raviglione, Director of the Stop TB Department of WHO said “In the past few years we have made encouraging progress in the fight against TB and also gained clear understanding of what needs to be done to prevent a million deaths from TB among people living with HIV by 2015. Now is the time to apply that knowledge and further intensify our efforts starting with bold leadership of national governments”. This was further echoed by Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB and former President of Portugal, who made a strong appeal during the launch of the publication “There is a surge in awareness about the deadly TB epidemic among people living with HIV, but insufficient action. Now new scientific work has shown that we can prevent a million deaths among people living with HIV by end 2015 by providing integrated HIV and TB care. I call on the world’s leaders to take up this challenge. It is time to take bold action. Not to do so would be an outrage."
Link to the publication | Link to a fact sheet about the model
Workshop to accelerate the implementation of the Three I's for HIV/TB and earlier initiation of ART in Southern Africa
Johannesburg, South Africa, 14-18 March 2011
WHO, in collaboration with the US Centers for Disease Control and Prevention (CDC) and the Office of the US global AIDS Coordinator (OGAC), conducted a five-day workshop in Johannesburg, South Africa, 14-18 March 2011, to accelerate the implementation of the Three I's for HIV/TB and earlier initiation of ART in Southern Africa. Participating countries were: Botswana, Lesotho, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. The objectives of the meeting were to review the status of implementation of the Three I's for HIV/TB and earlier initiation of ART in the Region; share best practices and discuss enablers and challenges for nationwide scale-up; identify priority actions to improve recording and reporting formats and strengthen monitoring and evaluation; discuss the role of civil society; draft country specific action plans including priority actions to scale-up the Three I's for HIV/TB and earlier initiation of ART, and identify follow-up mechanisms. For further details, please click on the links below:
Workshop Report | Agenda | List of Participants | Presentations
TB/HIV summary from CROI 2011
TB/HIV Research Frontiers meeting, 27 February, 2011 | Boston, USA
The Stop TB Department of the World Health Organization and the Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE) organized an HIV/TB research frontiers meeting on behalf of the TB/HIV Working Group of the Stop TB Partnership affiliated with the 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011) in Boston, USA on 27 February, 2010. This was the fifth in a series of annual meetings organized by WHO and CREATE in conjunction with CROI. The meeting was co-chaired by Dr Diane Havlir, the chair of the TB/HIV Working Group and Dr Richard Chaisson from Johns Hopkins University and CREATE, and was attended by about 80 HIV researchers and policy makers, including Ambassador Eric Goosby, the United States Global AIDS Coordinator.
The main objective of the meeting was to discuss emerging and unpublished data about the new Xpert MTB/RIF diagnostic tool and explore its implication in the diagnosis of TB among people living with HIV. The meeting also discussed the implication of the mouse model for the development of new TB drugs and explored its implication for people living with HIV. Dr Catharina Boehme from the Foundation for Innovative New Diagnostics (FIND) presented previously published and unpublished data on Xpert MTB/RIF, which has the sensitivity of a single Xpert test under routine conditions of 99% and 80% in smear positive culture positive and in smear negative culture positive specimens respectively. The performance of the test was not affected by HIV status. The use of Xpert resulted in shortening of time to case detection and treatment, and improved reporting of results as compared to routine practices. Preliminary results also showed that Xpert MTB/RIF perform better in those children living with HIV compared to HIV negative children. Results from preliminary studies also showed that Xpert performance is higher when used on extrapulmonary specimens except for cerebrospinal fluid. (See also a poster presented at the main conference describing the performance of Xpert MTB/RIF on fine-needle aspiration specimens with a sensitivity and specificity of 100% and 93.8% respectively (Van Rie, abstract 879, CROI 2011). Dr David Katzenstein of Stanford University, USA commented on Dr Boehme's presentation and underlined the role of the test in preventing the loss to follow up of patients after the first sputum test. He also urged on the importance of including INH resistance detection in the Xpert test.
Dr Eric Nuermberger of Johns Hopkins University presented data on the use of mouse model to develop new TB drugs and regimens and discussed its implication for people living with HIV. He described that the pathological differences between mice and humans have raised concerns about the "predictiveness" of mouse models in the development of new TB drugs. Nonetheless, mouse models represent the activity of existing TB drugs well and their careful use can inform TB drug development. Dr Annie Luetkemeyer from the University of California, San Francisco commented on the need to include people living with HIV in clinical trials and to improve surrogate markers to better predict the potency of new drugs and regimens.
TB/HIV at the main conference
The results of two randomized control trials on when to start ART in TB patients living with HIV were presented at the main conference. The STRIDE study compared immediate ART (2 weeks after TB treatment initiation) to early ART (within 8 to 12 weeks) among 806 people living with HIV with CD4 count <250 celles/mm3 recruited from study sites in Africa, Asia, Latin America and North America. The SAPIT trial compared two integrated arms of early (ART initiated within 4 weeks of TB treatment initiation) and late therapy (ART initiated within the first 4 weeks of the completion of TB treatment continuation phase i.e. at 12 weeks). Both studies showed that combined and earlier ART and TB treatment reduces death and AIDS related events with more pronounced effect among those people with CD4 count less than 50 cells/mm3. Death and AIDS events were significantly reduced in the immediate than the early arm in those with CD4 count <50 cells/mm3 by 42% and 68% in the STRIDE and SAPIT trials respectively. TB IRIS was significantly higher with immediate ART than early ART but no deaths were attributed to IRIS. A symposium entitled "Colliding epidemics: Controlling HIV-related TB" and co-convened by Drs Haileyesus Getahun of the Stop TB Department of WHO and Connie Benson of University of San Diego reviewed the management of patients requiring treatment for both TB and HIV diseases, advances in TB diagnostics among people living with HIV, the use of preventive TB therapy, and the challenges and progress in understanding the immune response to TB infection for vaccine development.
New Rapid Diagnostic test Xpert MTB/RIF endorsed by WHO
In December 2010, the World Health Organization (WHO) endorsed the new rapid diagnostic test for tuberculosis and rifampicin resistance named "Xpert MTB/RIF". This new diagnostic test promises to have a great impact on the community of people living with HIV. Evidence to date has shown that it could double the number of HIV-associated TB cases diagnosed in areas of high rates of TB and HIV. Click here for further information
New guidelines on Intensified Case Finding and Isoniazid Preventive Therapy for People Living with HIV in resource constrained settings
These new guidelines were launched on 1st December, World Aids Day and aim to provide guidance to national AIDS and tuberculosis programmes and those providing HIV services to accelerate the nationwide implementation of IPT and ICF. They include evidence-based recommendations for adults, children and infants living with HIV, address implementation issues and identify key research gaps in order to scale up TB prevention, diagnosis and treatment as a core component of HIV prevention, treatment and care. They are aimed at policy-makers and health programme managers, governments, nongovernmental organizations, donors and patient support groups working in the field of HIV/AIDS and TB, and health-care workers providing care for people living with HIV. The new guidelines can be accessed here.
Intensive case finding and isoniazid preventive therapy guidelines, 2010
Priority research questions for TB/HIV in HIV-prevalent and resource-limited settings, 2010
