Why do HIV / AIDS (PLHA) patients need to have their TB checked immediately?

HIV (Human Immunodeficiency Virus) is a virus that attacks the human immune system. The weak immune system makes people very susceptible to other diseases. HIV is likened to a gateway that opens wide for other infections to enter the body. Another disease most often associated with HIV is TB (Tuberculosis). TB is a disease caused by bacteria, can attack the lungs and other parts of the body. For people who have HIV / AIDS (PLWHA), you must immediately check for TB.

What is the relationship between HIV and TB?

Basically, the impact of HIV infection is damage to the immune system. Because of this weak immune system, people living with HIV (PLWHA) are weaker to the presence of any bacteria from outside, including TB bacteria.

In fact, almost all HIV sufferers already have TB bacteria in their bodies, some are active or not yet active. The link between TB and HIV is very close, given the fact that the number of TB cases is increasing in countries with high cases of HIV infection.

Why do PLWHA have to check TB immediately?

Everyone actually has a risk for getting TB. However, people living with HIV are more prone to experiencing TB. TB bacteria in PLWHA become active faster than if these bacteria are in healthy people. In fact, although TB cases in PLHIV become active more quickly, this infection will be more difficult to diagnose and treat.

So, PLWHA should check for TB infection as early as possible. In certain cases, if TB has not been detected, and it is experienced when this HIV patient has experienced a very damaged immune system, it is very difficult to treat. Not infrequently, patients with HIV die within days or weeks of starting TB therapy. This emphasizes the importance of HIV sufferers having to check TB immediately, so that it can be handled more quickly.

What are the signs if PLWHA has TB?

According to the US Department of Health and Human Services, there are several signs or symptoms if you have TB, namely:

Coughing up phlegm or coughing up phlegm with blood that continues for 3 weeks or even more.
Body weight is decreasing.
Fever, especially in the afternoon.
Sweat can get soaking wet at night. This sweat is like getting wet in the rain.
Swollen glands, generally swollen glands in the neck.

Dry cough should also be watched out, because TB bacteria that attack the lungs can also cause this symptom.

What tests do people living with HIV need to undergo to check for TB?

There are three common tests for TB that can be done, namely:

Tuberculin Skin Test (TST), also known as the Mantoux test
X-ray (X-ray) of the chest
Sputum or sputum test

These three tests can detect whether a person has active TB infection or not, or is not infected with TB at all, aka clean.

What if the result is negative for TB?

Some people with HIV infection will have a negative TB test result, even if they are actually infected with the TB germs. This is because the immune system that is causing the test reaction is not working properly. People with HIV who have a negative TB test usually need further medical examinations, especially if they experience symptoms of TB.

What if the results have active TB?

As is the case with HIV, TB must also be treated with a combination of several drugs. If the results of the examination do indicate active TB, your doctor will usually give you certain drugs.

Taking HIV and TB drugs at the same time can increase the risk of drug interactions and side effects on your health. Therefore, people who are being treated for TB and HIV infection should be monitored very carefully by medical personnel.

There are 5 choices of drugs that are usually used in Indonesia, namely:

Isoniazid (marked with an INH or H code)
Rifampin (R)
Pyrazinamide (Z)
Ethambutol (E)
Streptomycin (S)

Which option is used depends on the patient's circumstances. For example, there are some drugs that cannot be used during pregnancy. You will need to talk to your doctor about these medications. In addition to the combination of these drug options, pyridoxine pills will usually be given. Pyridoxine is vitamin B6 which is used to reduce the side effects of these TB drugs.

So what if inactive TB bacteria are found?

If the TB test results show the presence of TB bacteria but are still not active, there are ways to prevent them from becoming active quickly. Prophylaxis is usually given by medical personnel. However, the use of this prophylaxis must really be ascertained first that it is indeed TB in the body that is not yet active. You cannot immediately give prophylaxis before you check the condition of the TB bacteria.

Apart from prophylaxis, prevention of the active TB bacteria can be started from the environment. A clean environment, good air circulation, and sufficient lighting from the sun is needed to prevent the development of TB disease from becoming active in PLWHA.