Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, June 4, 1995                   TAG: 9506060065
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-10   EDITION: METRO 
SOURCE: The New York Times
DATELINE: WASHINGTON                                LENGTH: Medium

HIV AND TB PRODUCE DEADLY COMBINATION

International health officials met last week in Geneva to determine how to cope with the growing threat of the deadly combination of AIDS and tuberculosis.

They said the dual epidemics are not only causing more deaths, but also are crippling efforts to control each of the diseases.

As the incidence of infection with HIV, the virus that causes AIDS, rises in Asia and other parts of the world where tuberculosis is common, the highly contagious lung disease will take an even greater toll on people whose protective immune systems have been weakened by HIV, the officials said Friday.

By the end of the decade, they said, about one-third of all deaths among HIV-infected people will result from tuberculosis.

``Now the HIV epidemic has made tuberculosis an even greater menace, including reversing many of the gains we had made against tuberculosis over the years,'' Dr. Paul Nunn, chief of research for the WHO Global Tuberculosis Program, said in a telephone interview.

The presence of HIV infection also makes diagnosing tuberculosis harder, he said. HIV-infected people often falsely register negative for tuberculosis with common tests that require an immune response, resulting in delayed treatment and increased chances of passing the lung disease on to others.

Tuberculosis is a bacterial disease transmitted through the air. Those infected with the tubercle bacillus, which produces symptoms that include fever and violent coughing, can spread the germ to others through sneezing, coughing or even talking.

The disease infects hundreds of millions worldwide and kills three million people a year, health officials say.

An estimated 16 million people worldwide are infected with HIV, including up to 1 million in the United States, Nunn said. Those infected with the virus become increasingly susceptible to diseases such as tuberculosis that prey on weakened immune systems.

In the United States, where tuberculosis also is on the rise among those who are HIV-positive, the major killers are pneumonia and Kaposi's sarcoma, a cancer.