| Tuberculosis (TB)
What is TB?
TB (Tuberculosis) is a disease caused by bacteria (germ) that is
spread through the air usually when a person who has the disease
coughs, sneezes or breathes. Anyone can become infected with TB
bacteria, but people with HIV/AIDS are at greater risk of getting
sick with TB disease. Although TB can occur any place in the body,
only TB disease in the lungs (pulmonary TB) or throat is contagious.
TB can occur at any T-cell range above or below 200 T-cells.
What is the difference between TB infection and TB disease?
TB infection (latent TB) means that TB bacteria have gotten inside
your body but are not active. People who are infected with TB usually
have no symptoms and most do not become ill. They are not contagious.
TB disease (active TB) means that the TB bacteria have become active
in your body and will make you sick. Only people with active TB
disease can spread TB to others. TB disease can be prevented or
cured, but if left untreated, it can be fatal.
What are the signs and symptoms of TB disease?
General symptoms of TB disease in the lungs or throat include fever,
night sweats, weight loss, and fatigue. Pulmonary TB causes a persistent
cough and sometimes bloody sputum (mucus). TB disease can occur
with other infections, especially Pneumocystis carinii pneumonia
(PCP) and Mycobacterium Avium Complex (MAC).
How is TB diagnosed?
To diagnose TB infection, your healthcare provider will give you
a special skin test called a TST (Tuberculin Skin Test), which causes
a bump to appear within several days if you are infected. A positive
test means you have TB infection. If you have HIV the TST might
not work. So to determine if you have active TB disease, a chest
x-ray and sputum cultures need to be done. If you have a negative
TST and are HIV positive, it is recommended that you receive a TST
every six months to a year depending on your risk of coming in contact
with the TB bacteria.
Can Active TB be prevented?
Yes. People with both HIV/AIDS and TB infection have an 810% risk
per year of developing active TB disease. So Isoniazid, also called
(INH) is used to prevent active TB. It is taken for 9 months. Rifadin®
(rifampin) or Mycobutin® (rifabutin) along with (PZA) pyrazinamide
can also be taken for 2 months. Your doctor should check you monthly
for side effects. If you are infected and cannot take medicine to
prevent TB disease, it is very important to have regular check-ups
and contact your doctor as soon as you have signs of active TB disease.
Also, remember to always cough or sneeze into tissues and ask others
to do the same.
Can TB be treated?
Yes. TB disease can be treated and cured with medication. TB treatment
starts with at least four drugs, but the number of drugs may be
reduced after two months. People with HIV/AIDS have to take the
drugs for a longer time than people without HIV. It is important
to take all your medication until the doctor says that the TB has
been cured. Skipping medication or stopping because you feel better
might lead your TB to become contagious again. Your TB might become
harder to treat and you might get sicker. Some drugs commonly used
to treat TB include:
INH (Isoniazid)—side effects: liver problems,
neuropathy (pain or tingling in your hands and feet), fever or rash.
Drug tips: take with food to reduce stomach problems, take vitamin
B6 to reduce neuropathy, do not drink alcohol (increases liver problems).
Rifadin® (Rifampin)—side effects: liver problems,
fever, flu-like symptoms, can turn your body fluids orange (urine,
feces, cum) and permanently stain soft contact lenses. Patients
on methadone may need up to 50 percent increase to avoid withdrawal
symptoms. Drug tips: do not drink alcohol, do not take with food
(skipping medication may cause flu-like symptoms).
Additionally, rifampin should NOT be used with any of the currently
available protease inhibitors. Rifampin reduces protease inhibitor
levels by more than 90 percent while protease inhibitors increase
rifampin levels.
Mycobutin® (Rifabutin)—side effects: irritation
of the eye, skin rash, stomach pain and nausea; can also cause the
same orange color changes to body fluids as rifampin.
Myambuto® (Ethambutol)—side effects: nausea,
vomiting, eye problems and skin rashes
PZA (Pyrazinamide)—side effects: nausea, vomiting,
rashes, liver problems, joint aches and pains. Drug tips: drink
plenty of fluids daily
What is MDR-TB?
MDR-TB (multiple-drug resistant tuberculosis) is TB that is resistant
to at least two of the standard drugs used to treat TB (INH and
Rifampin). It means these drugs don’t work as well, or not at all,
on your TB. Your TB can become resistant if you are not treated
long enough, do not receive the right drugs or if you don’t take
your medication properly.
You can also become directly infected with MDR-TB. MDR-TB can cause
death within a few weeks in people with HIV/AIDS. So preventive
treatment of suspected MDR infections is highly recommended. Treatment
of MDR-TB disease requires the use of five or six drugs.
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