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:
Civil Society Meeting for Accelerating Advocacy on TB/HIV in the Region of the Americas, Panama City, Panama - 6 July, 2011
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:
Accelerating Advocacy on TB/HIV in the WHO European Region
The one-day workshop prepared HIV and drug use civil society activists for active participation at the European Regional meeting on 16th-17th and to further advocate for increased access to collaborative TB/HIV services, particularly for people who use drugs in their own countries and throughout the region. The objectives of the workshop were to familiarize participants with the key facts about TB and TB/HIV, the relationship between TB and drug use, approaches to improve prevention, diagnosis and treatment of TB for people living with HIV and in people who use drugs. This was the third workshop of its kind and built on the experience of the previous two workshops held in Bangkok in November 2009 and in Liverpool in June 2010.
Workshop to build the capacity of civil society for people who use drugs
The two day advocacy workshop familiarized participants with the integrated TB/HIV and harm reduction policy guide to address the problem of HIV associated TB among drug users, and how to catalyze implementation in countries with drug use problems which is critical to the health of drug users and contributes towards universal access of TB and HIV services for people living with HIV. The workshop held in Liverpool, UK from June 10-11, 2010 was highly interactive and participants developed a better understanding of the concerns and needs of the community of people who use drugs around TB and HIV and how best to respond to these needs. It also gave those attending an opportunity to network with each other and build momentum to catalyze implementation of a fully integrated approach based on the needs of people who use drugs in their countries and regions. The next steps are to develop strategies to enhance community mobilization for implementation of collaborative TB/HIV and drug user services and demand generation for the services.
TB/HIV Research Frontiers meeting
16 February, 2010 | San Francisco, USA
The Stop TB Department of the World Health Organization and the Consortium to Respond Effectively to the AIDS/TB Epidemic organized an HIV/TB research frontiers meeting on behalf of the TB/HIV Working Group of the Stop TB Partnership affiliated with the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) in San Francisco, USA on 16 February, 2010.
This was the fourth in a series of meetings organized by WHO and CREATE since 2007. The meeting was co-chaired by Dr Kenneth Castro, Assistant Surgeon General and Director of Division of Tuberculosis Elimination Centers for Disease Control and Prevention and Dr Alison Grant, Head of the Clinical Research Unit in London School of Hygiene and Tropical Medicine. The meeting was opened by Dr Diane Havlir, the chair of the TB/HIV Working Group who described the popularity of the meetings among HIV researchers to stimulate scientific debates and discussions around HIV/TB. The meeting was attended by more than 65 HIV researchers and public health policy makers.
The main objective of the meeting was to promote high level scientific interchange of ideas and debates around isoniazid preventive therapy (IPT) and its role in improving survival among people living with HIV so as to generate questions for future research. New data on the impact of IPT on mortality of people living with HIV was presented from Botswana, India and South Africa.
Dr Craig Innes (presentation [416KB]), from Aurum Institute of South Africa presented the result of a retrospective observational study of more than 3200 patients on ART, which shows the combined use of IPT and ART may reduce the risk of death by nearly 50%.
Dr Soumya Swaminathan (presentation [704KB]), from the TB Research Center in Chennai, India presented a randomized controlled trial with a sample size of 752 that compares 6 month INH and Ethambutol versus 36 month INH which showed no statistically significant difference in mortality in both arms. She said most of the mortality occurred during the first 12 months and there was no difference in mortality based on tuberculin skin test (TST) status. Dr Taraz Samandari from CDC presented a preliminary report of mortality from the Botswana IPT randomized controlled trial with a sample size of 2000 that compares 6 month IPT versus 36 months. He reported that there was non-significant increase in mortality in the 36 months arm than the 6 months. They observed three fold increased death in TST negatives as compared to TST positives, in contrast to the Indian trial. However, further clinical characterization of the two deaths that were attributed to hepatic encephalopathy (observed among TST negatives) was not conclusive.
Dr Richard Chaisson of John Hopkins and CREATE provided commentary on the role of IPT and mortality and underscored the primary objective of IPT is to prevent TB rather than improving survival. He stated the reasons for absence of significant gain in survival out of IPT including most studies are not powered to look survival benefit and patients enrolled in the trials are often not those with advanced stage of disease and are under active surveillance and follow-up.
Dr Haileyesus Getahun (presentation [32KB]) of WHO presented the outcome of a primary patient meta-analysis that was done to develop a rule to screen people living with HIV to put them on IPT and further investigations for TB or other diseases. He also shared the upcoming draft WHO recommendations on IPT and intensified TB screening among people living with HIV.
Dr Alison Grant (presentation [736KB]) of London School presented on the role of IPT in settings with high rates of drug resistance TB. She presented summary of the evidence and stated that IPT does not promote drug resistance TB and actually protection from IPT no is no worse with a background of INH resistance. However, she stated that there is scanty information that IPT may be less ineffective in individuals with latent INH resistant TB. There is no evidence about threshold prevalence of INH resistance at which IPT risks exceed benefits. Similarly there is no data on what to do for contacts with MDR TB cases and the available international guidelines are not consistent to each other. She suggested placebo controlled trials for MDR contacts using drugs like high dose INH, fluoroquinolones or new agents (e.g. TMC 207).
Preventive therapy and intensified case finding for TB in people living with HIV
25-27 January 2010 | Geneva, Switzerland
The WHO HIV/AIDS and Stop TB Departments hosted a joint meeting with key experts, 25-27 January 2010, to prepare guidelines on preventive therapy and intensified case finding for TB in people living with HIV. The new guidelines will update the WHO/UNAIDS 1998 Policy statement on preventive therapy against TB in people living with HIV and produce new WHO guidelines, reconceptualising TB preventive therapy and intensified TB case finding, as integral parts of HIV treatment, care and support services.