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Steep rise in patients with TB/HIV co-infections across Europe, warns WHO

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The number of patients with co-infections of HIV and tuberculosis has risen 40% across Europe over the last five years, despite an overall reduction in new TB cases, according to latest figures.

New data released today show that new TB cases and deaths in the 53 countries of the World Health Organization’s European region declined each year by 4.3% and 8.5%, respectively, from 2011-15.

“One in three people co-infected with TB/HIV do not know about their status”

Zsuzsanna Jakab

But groups, such as people with HIV, prisoners and migrants, did not benefit from the trend, said the European Centre for Disease Prevention and Control and the WHO Regional Office for Europe in their report Tuberculosis surveillance and monitoring in Europe 2017.

In particular, they said new TB/HIV co-infections increased sharply by 40% over the five-year period in the WHO European region, from 5.5% to 9%.

The trend was of special concern in a region where HIV cumulative cases reached over 2 million for the first time in 2015, said the organisations.

Of an estimated 27,000 new TB/HIV patients in the WHO European region in 2015, only about two thirds were diagnosed and 5,800 started antiretroviral treatment.

The two bodies suggested that providing testing to all TB patients for HIV and vice versa, together with counselling and rapid treatment, could reverse the negative trend.

They highlighted that patients with TB/HIV co-infection were at seven times higher risk of failing treatment and had a three times higher risk of dying than people with TB disease only.

Similar to the trend across the WHO European region, the number of new TB cases in the European Union and European Economic Area has constantly been going down since 2002.

However, even with the annual decrease of 5%, the EU/EEA will not reach the set target to end TB, which would require an annual decrease of at least 10%.

But in contrast to the region’s trend, EU/EEA countries have seen a decline in reported TB/HIV co-infections from around 6% in 2011 to 4.6% in 2015.

Meanwhile, new cases of multidrug-resistant TB continue to rise, and estimates suggest one in five multidrug-resistant MDR-TB cases globally in 2015 occurred in the European Region.

World Health Organization

Steep rise in patients with TB/HIV co-infections across Europe

Zsuzsanna Jakab

Although the number of multidrug-resistant TB patients successfully treated increased for the first time in 2015, only half had a positive treatment outcome, which is far below the 75% target.

The rate of notified multidrug-resistant TB cases in the EU/EEA has remained unchanged over the past five years at 0.3 per 100,000 population.

While the multidrug-resistant TB treatment success rate has continuously improved over the past five years, from 30% in 2009 to above 40%, it remains low overall.

Dr Zsuzsanna Jakab, WHO regional director for Europe, said: “The flare-up of TB/HIV co-infections from 2011 to 2015, together with persistently high rates of drug-resistant tuberculosis, seriously threaten progress made towards ending TB, the goal that European and world leaders have committed to achieve by 2030.

“One in three people co-infected with TB/HIV do not know about their status, which drastically lowers their chances of being cured. In turn, this favours the spread of the diseases, putting health systems and governments under pressure,” she added.

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