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Preventing TB
In the UK and many other European countries, schoolchildren aged 12-14 were given a BCG vaccination against TB. However, this vaccination does not offer complete protection against TB, and there have been many cases of people who received the BCG jab as a child developing TB.
People who are HIV-positive should not be given the BCG jab, as it is a live vaccine and can cause a TB-like illness.
Preventing TB - Improving the immune system with anti-HIV treatment
One of the best ways of preventing TB in people with HIV is to improve the immune system. Treatment with potent combinations of effective anti-HIV drugs boosts the immune system, enabling it to fight TB and other infections.
Preventing TB - taking anti-TB drugs (prophylaxis)
People with latent TB are sometimes given an anti-TB drug or drugs to prevent the TB becoming active. The drug normally used is called isoniazid, which is given for six at least months. It is recommended that HIV-positive people who come from communities that have high levels of TB, including Africans and those from the Indian sub-continent, are given if PPD-positive. It is also recommended that HIV-positive people who have been in close contact with people with active TB should receive this treatment.
However, there are concerns about the safety of this approach, as it could lead to the development of drug-resistant TB if the latent TB is really active TB that has not been correctly diagnosed. Also, isoniazid can cause side-effects and interact with some anti-HIV medicines, particularly ddI (didanosine, Videx) and d4T (stavudine, Zerit).
Isoniazid can also be harmful to the liver, and you will be to have your liver's function
monitored closely as long as you are taking isoniazid.
Isoniazid can also be used to prevent TB from recurring in people who have been ill from it. However, this is not recommended. There are concerns about side-effects and there are questions about how effective it really is when used in this situation.
Helping yourself
Eating well, getting an adequate amount of sleep and living in dry, well ventilated housing will help you avoid infection with TB or stay well if you have been exposed to it or have latent TB. The booklet Nutrition, which is also produced by NAM in this series, gives some tips on healthy eating. If you cannot afford to eat properly or have housing problems help may be available to you. Try contacting THT Direct whose contact details are provided at the back of this booklet. They should be able to put you into contact with somebody who can provide you with advice, help and information.
If you come into contact with somebody with TB, such as a family member, housemate or friend, then you should go to your HIV clinic as soon as possible for tests to see if you have been infected.