Treating patients living with HIV and tuberculosis

Nurses carefully prepare the pills for each TB patient in advance in Nukus, Uzbekistan. Some patients with multi-drug resistant tuberculosis (MDRTB) take as many as 20 to 30 pills per day.
UZBEKISTAN 2007 © Donald Weber/VII
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This information is excerpted from MSF’s 2017 International Activity Report.

Tuberculosis (TB) and HIV care continue to be the focus for Doctors Without Borders/Médecins Sans Frontières (MSF) in Uzbekistan, which is among the 27 countries with the highest rates of multidrug-resistant TB.

TB program

In January, MSF launched its clinical trial TB PRACTECAL in Nukus, Karakalpakstan, and had enrolled 55 patients by the end of 2017. The trial aims to evaluate regimens containing two promising new drugs, bedaquiline and pretomanid, combined with existing and re-purposed drugs, over a much shorter course of six months. This treatment has the potential to be more effective and more tolerable, and does not require injections.

As part of the comprehensive TB care program in Karakalpakstan, MSF works with the national and regional health ministries to implement models of care that are more patient-centered. In 2017, MSF supported the roll-out of the new World Health Organization guidelines in five of 16 districts.

During 2017, 2,466 patients started TB treatment. Of these, 1,710 were treated for drug-sensitive TB and 756 for drug-resistant strains, including 79 for extensively drug-resistant TB (XDR-TB). Of the 756 drug-resistant TB patients, 130 were treated with new or re-purposed drugs.

HIV care

Working with the health ministry at the Tashkent HIV project, MSF has set up a ‘onestop shop’ facility to support the integration of services for HIV, TB, hepatitis C, and provide more effective testing and treatment for co-infected patients. In 2017, MSF and the Republican AIDS Center reached an agreement that MSF will test and treat high-risk groups, such as people who inject drugs and sex workers.

In 2017, 153 patients started treatment for hepatitis C and 14 patients were initiated on third-line antiretroviral (ARV) treatment for HIV, after their initial and subsequent regimens ceased to work. Almost 880 patients started first-line ARV treatment in 2017.