90-90-90 HIV targets: implications for HIV-associated tuberculosis

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Abstract

Purpose of review

The HIV and Mycobacterium tuberculosis syndemic remains a major global public health threat. HIV and tuberculosis (TB) global targets have been set. Success will depend on achieving combined disease control. We explore current policy, economic investment, and disease control strategies for HIV, TB, and HIV-associated TB. We review published HIV, TB, and HIV-associated TB data for 30 WHO priority countries and propose a comprehensive HIV and TB care continua.

Recent findings

In 2016, people living with HIV (PLHIV) on antiretroviral treatment (ART) ranged from 13 to 84%; viral suppression ranged from 21 to 79%. Only 5% of PLHIV without TB reported a course of isoniazid preventive therapy (IPT). TB treatment success (2015) ranged from 34 to 94%. Data for the combined indicators: TB treatment success and viral suppression and IPT and ART for PLHIV are not collected. Reported 2003–2017 global international and domestic resources for TB and HIV-associated TB averaged $2.9 billion per year; cumulative total was $43 billion.

Summary

Integrating HIV and TB control efforts including monitoring and evaluation systems will be necessary to end both TB and HIV. A comprehensive HIV and TB continuum supports integrated, comprehensive HIV and TB disease control efforts focused on improving both individual and public health.

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