What is tuberculosis (TB)?
(TB) is a disease caused by a bacteria (germ) that spreads through the air, usually when someone suffering from this disease coughs or sneezes. Anyone can be infected with TB bacilli, but those that are HIV Positive people are at greater risk of contracting the disease. Although TB can occur anywhere in the body, only lung and throat TB are contagious. TB can occur in any count range of CD4 cells, either above or below 200.
What is the difference between TB infection and TB disease?
The infection TB (Latent TB) only means that TB bacilli penetrated your body. People with TB usually do not have symptoms, and most do not develop the disease or transmit it.
Having TB disease (Active TB) means that TB bacilli have come into activity in your body and will cause you to become ill. Only people with active TB can pass it on to others. This disease can be avoided or cured, but without treatment it can be fatal.
What are the signs and symptoms of TB disease?
The general symptoms of TB disease are fever, night sweats, weight loss, fatigue and anorexia. Pulmonary TB causes persistent coughing and sometimes sputum blood (catarrh). TB disease can occur along with other infections, especially Pneumocystis carinii (PPC) and mycobacteriosis (Mycobacterium avium complex - MAC).
How can a doctor tell if I have TB?
To diagnose TB infection, it is necessary to have a special skin test, called PPD (Mantoux test), which causes swelling for several days if you are infected. A positive test indicates that the person has TB infection. To find out if you have active TB disease, you need to have chest x-ray and sputum culture. If you have HIV, the PPD test may not work.
Can TB be avoided?
Isoniazid, also called INH, is an antibiotic in pills approved for the prevention of the disease. (Editor's note: As I lived in a nursing home that was considered a “tuberculosis outbreak” I had to go through this one too). It should be taken for at least a year and is indicated for all people with HIV who are positive for the PPD test. People with HIV and also with TB infection have 10% risk of developing active TB disease. Your doctor should monitor the INH side effects monthly. If you are infected and can not take medicine to prevent TB disease, it is very important to have regular medical appointments and to contact your doctor as soon as you begin to show signs of active TB disease. Remember: Whenever you cough or sneeze use tissues and ask others to do the same.
Is there treatment for TB?
Yes. TB disease can be treated and cured with medication. TB treatment begins with at least four drugs, but that number can be reduced after two months. People with HIV need to take the drugs longer than others. It is important that you take all the medication until the doctor ensures that the TB is cured. Skipping time or stopping your medication because you feel better can make your TB become contagious again. It can also get harder to be treated, and you may get worse.
Some medicines commonly used to treat TB:
ISONIAZID (INH) - side effects:
Liver problems, pain or tingling in the hands and feet (neuropathy), fever and rash. Tips: Sometimes it should be taken fasting, and others with food to reduce stomach problems; take vitamin B6 to reduce neuropathy; do not drink alcohol (increase liver problems); do not use antacids containing aluminum, or laxatives (reduce absorption of INH).
RIFAMPICINA Side effects: Liver problems, fever, flu-like symptoms can turn your body fluids orange (urine, stools, secretions) and cause permanent staining on soft contact lenses. Patients on methadone treatment may need up to 50% increase to avoid withdrawal symptoms. Tips: Do not drink alcohol; do not take with food; skipping medication schedules can cause flu-like symptoms.
ETAMBUTOL - side effects: nausea, vomiting, eye problems and rash.
PYRAZINAMIDE - Side effects: nausea, vomiting, rash, liver problems, joint pain. Tips & Warnings Drink plenty of fluids daily.
STREPTOMYCIN (injectable) - side effects: kidney, hearing and blood problems.Tips: Warn your doctor about any fever, nausea, vomiting, rash, allergic reaction, dizziness, hearing loss, or difficult breathing.
P-AMINOSSALICYLIC ACID (PAS) - side effects: severe allergic reaction, nausea, liver problems, vitamin B12 deficiency and blood problems. Tips: Take food to reduce stomach problems; Tell your doctor about a rash, fever, sore throat, unusual bleeding or bruising.
What is resistant tuberculosis (TBR)?
TBR is treatment-resistant tuberculosis for at least two of the drugs commonly used to treat TB (INH and rifampicin). Your TB can become resistant if you do not receive treatment long enough, do not take the right medicines or take them inappropriately. You can also become infected directly with TBR. As TBR often causes the death of people with HIV within a few weeks, preventive treatment of suspected TBR infections is highly recommended. Treatment of TBR requires the use of five or six drugs, which vary according to the drug resistance pattern in your geographical area.
More Information: “Guide to Clinical Conduct in STD /AIDS”, Of the Ministry of Health's National STD / AIDS Program.
This material was edited in Brazil by the Brazilian Interdisciplinary AIDS Association (ABIA) from the series “TREATMENT ISSUES, FACT SHEET - GMHC”.
Medical Review: Dr Rosana Del Bianco, Emilio Ribas II infectious disease of the St. Paul and Dr. Varella Dráuzio.