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The connection between TB and HIV - Factsheet

This is a fact sheet about Tuberculosis (TB) and Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS). People with HIV are more likely to get sick with other infections and diseases. TB is one of those diseases. If you have been diagnosed with TB or if you have HIV, this fact sheet is for you.

Of the estimated 40 million people living with HIV or AIDS, around 13 million also have TB. Early detection is important if you have HIV as well as TB so you can start treatments for both HIV and TB. If these two infections are not treated, they can work together to cause very serious illnesses.

Section 1: Tuberculosis (TB)

What is TB?
TB is caused by a bacterium (germ). It is a disease that usually affects the lungs but it can affect other parts of the body, such as the brain, the kidneys, or the spine. TB can be active in the body or latent (sleeping). If it is not treated, active TB can cause serious health problems, or even death.

How is TB spread?
TB bacteria (germs) are spread from person to person through the air and are usually spread when a person with active TB coughs, laughs, sneezes or sings. Anyone nearby can breathe in these TB bacteria and get TB. TB is NOT spread by sharing household utensils, cups or plates, or by saliva when kissing someone.

What are the symptoms of active TB?
People with active TB often:

• feel weak or sick,
• lose weight rapidly
• have a cough (sometimes with blood) and chest pain
• have a fever, and
• have night sweats
• or sometimes have no symptoms

What is the difference between active TB and latent TB?

People with active TB are sick from the large number of TB germs that are active in their body. People with latent TB also have the bacteria that cause active TB, but they are not sick because the bacteria is latent (sleeping) in their body. Usually they have been exposed to TB bacteria in the past. However, people with latent TB can develop active TB in the future, especially if they also have HIV.

SECTION 2: HUMAN IMMUNODEFICIENCY VIRUS (HIV)

What is HIV?
HIV is the virus that can cause AIDS. HIV attacks the body's immune system. If you have been infected with HIV you are said to be HIV-positive. This means HIV has entered your bloodstream.

How is HIV transmitted?
HIV is found in body fluids such as blood, semen and vaginal fluids, and breast milk. HIV infection can only occur when one or more of these body fluids from an infected person enters the bloodstream of another person.

HIV is only transmitted in the following ways:

• Sex without a condom (unprotected sex)
• Sharing needles, syringes and other injecting drug equipment
• Mother to child during pregnancy, childbirth or breast feeding
• Blood transfusion and/or blood products (in Australia blood products have been screened for HIV since 1985)

HIV CANNOT be transmitted by: coughing, kissing, sneezing, spitting, crying, sharing cutlery, bed linen, toilets, showers or any form of casual contact.

What are the symptoms of HIV?
You can't tell just by looking if someone has HIV. Most people who have HIV look healthy and have no symptoms. It may take several years before any symptoms begin to show and many people who have HIV don't know it themselves.

What is the difference between HIV and AIDS?
HIV attacks the body's immune system. If it is not treated, HIV damages the immune system so that it is no longer able to fight off common infections and the person is at risk of illness and even death. This is the condition known as AIDS - Acquired Immune Deficiency Syndrome.

SECTION 3: TB AND HIV - TESTING AND SCREENING

HIV weakens the immune system - "it opens the door for other infections" -so, if you have HIV and latent TB, you are more likely to develop active TB. If these two infections are not treated, they can work together to cause very serious illness.

Why is it important to be tested for TB if I have HIV?
If you have HIV it is important to find out if you have latent TB, as latent TB is much more likely to progress to active TB in people with HIV. If you have latent TB as well as HIV, you can have treatment.

Why is it important to be tested for HIV if I have active TB?
If you have active TB it is important to find out if you have HIV as people with active TB are sometimes people who also have HIV. It is important to be tested so that if you have HIV as well as active TB, you can have treatment.

What tests do I need to do for TB?
Three common tests for TB can be done at any chest clinic in NSW. They are:

• The Tuberculin Skin Test (TST), also known as a Mantoux test
• A chest x-ray
• A sputum (spit) test

These tests can detect if you have been exposed to TB in the past (latent TB) or if you have active TB. The decision about which tests are needed will be made by the chest clinic.

What tests do I need to do for HIV?
A blood test for HIV can be done at any sexual health clinic in NSW or at your doctor.

What is the cost?
All tests for TB are FREE at chest clinics in NSW. You may need an appointment to attend a chest clinic but you do not need a Medicare card.

The HIV test is FREE at sexual health clinics in NSW and you do not need a Medicare card. It is also available at your local doctor but you need a Medicare card.

SECTION 4: TB AND HIV - TREATMENTS

Treatments for TB
Active TB can be treated and cured in people with HIV. Active TB is treated with a combination of antibiotics for at least 6 months. A nurse watches you take the TB medication to check for any side effects and make sure the treatment is completed.

Latent TB in people who also have HIV is treated by a 6 month course of antibiotics to prevent progression to active TB.

Treatments for HIV
There is currently no cure for HIV and AIDS, however many medications have been developed to fight HIV and slow down the damage the virus causes to the immune system. With treatments, many people with HIV are able to remain well and continue to live healthy, busy and fulfilling lives.

What is the cost?
All treatments for TB are FREE. A Medicare card is not needed.
Treatments for HIV are available to all people with a Medicare card for a small cost.

SECTION 5: OTHER INFORMATION

Will having HIV or TB affect my immigration status?
TB:
Having latent TB infection or active TB disease will NOT affect your immigration status in Australia.

HIV:
If you are a permanent resident, having HIV will also NOT affect your immigration status. However, all applicants for permanent residency are required to pass a health requirement which includes an HIV test and a chest x-ray. The laws and regulations about becoming a permanent resident are complex. Therefore it is important to get legal advice from a qualified Migration Agent.

Confidentiality
Confidentiality means that any information a health service has about you is private, and they cannot give that information to other people without your permission. In Australia it is against the law for any health care worker to discuss your private information with others.

Using Interpreters
You can have an interpreter when you are talking with health care workers or other services. Like all health care workers, interpreters MUST protect your confidentiality.

By using an interpreter you can:

• Understand everything you are being told
• Be sure everything you say will be understood
• Ask questions and get answers
• Be able to understand and consent to tests or treatment

Telephone interpreters (TIS) are also available anywhere in Australia. Call 131 450 (for the cost of a local call) and you will be linked with the service you want to speak to and with a telephone interpreter.