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Monday July 4, 4:32 PM
Japan faces potential AIDS-tuberculosis dual-epidemic, experts say - AP
Japan and other countries in Asia face a potential dual-epidemic of AIDS and tuberculosis that is being neglected by health officials here despite the danger of emerging drug-resistant strains of TB, doctors warned on Monday.
HIV-positive people are 50 times more likely to develop tuberculosis, or TB, a sometimes fatal bacterial infection spread through the air.
While overall TB cases have been on the decline in Japan, a rapidly surging number of HIV infections could lead to a sudden explosion of TB/AIDS cases among certain vulnerable sectors of the population, according to experts at the Seventh International Congress on AIDS in Asia and the Pacific in Kobe, Japan.
"When an ordinary person becomes infected with TB, they can usually be cured. But if inappropriate treatment is administered (to someone also infected with HIV), it can result in multiple drug resistance, which in the worst case can be more frightening than AIDS," said Dr. Nobukatsu Ishikawa from the Research Institute of Tuberculosis in Kiyose, Japan.
No figures are available for the number of people in Japan co-infected with HIV and TB. Worldwide, one-third of HIV-positive people, or 14 million, are co-infected with TB.
The overall decrease in TB cases in Japan is misleading because many elderly who were infected long ago are now dying, said Ishikawa.
About 30,000 new cases of TB are being reported here every year and many more could be going undetected because the disease is spreading quickest among vulnerable groups _ the poor, the homeless, low-income immigrants and young people _ who are unable or unwilling to seek medical help, Ishikawa said.
Takashi Sawada, a Japanese doctor and chairman at the congress, said as much as 40 percent of foreign HIV-patients he is treating in Japan are co-infected with TB.
"Within an overall decrease, pockets of crises are emerging," Ishikawa said.
As HIV-infections double here at a rate of every four years, calls for the government to take more urgent action have gained momentum.
But the TB threat has gone virtually unacknowledged, said both Ishikawa and Sawada.
TB funding is on the decrease, while upcoming changes in the health care system threaten to decrease coverage of TB treatment and shut out those most likely to have the disease, Sawada said.
"TB is one of the leading causes of death among HIV-positive people, especially in the developing world," said Javid Syed from New York-based Treatment Action Group.
A delay in addressing the HIV/TB threat in New York cost the city US$1 billion as multi-drug resistant strains of TB developed, he said.
Whereas treatment of an ordinary TB case costs between US$11 to US$20, the city saw those figures surge by more than a 100 times, he said.
"That's what Japan might be facing," Syed said.
The World Health Organization says, "HIV/AIDS and TB are so closely connected that the term 'co-epidemic' or 'dual-epidemic' is often used to describe their relationship."
The threat in Japan mirrors a larger one in the region.
Asia is home to the largest number of TB cases worldwide and the second-largest number of people with the AIDS virus. Escalating TB rates in places like Southeast Asia are mainly attributed to the HIV epidemic, officials at the congress have said.
Tuberculosis, or TB, is caused by a bacteria that is spread, like the common cold, through the air and normally enters the body through lungs. When it infects a person with HIV, TB progresses more rapidly to symptoms like coughing up blood, fever and weight loss that can ultimately be fatal.