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TB/HIV Co-infection (April 2009)

Summary
Dates of the event (from/to): 
Mon, 2009/04/13 - Fri, 2009/04/17
Type of Training: 
Management of HIV and TB Co-Infection
Training Center: 
Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia
Country of location: 
Ukraine
Location of training: 
Kiev
Country of trainees: 
Moldova
Base Institution: 
Lavra AIDS Clinic
Attendees: 
Infection disease doctors and TB specialists from Moldova
Photo gallery: 
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Trainers: 
Dr. Svetlana Antonyak, Lavra AIDS Clinic, Kiev; Dr. Olga Nikolayeva, TB Dept., National Medical Academy for Post-Graduate Education, Kiev
Source of funding: 
Funding was provided by WHO.
Agenda

DAY 1
10:00-10:30
Welcome, introduction of the participants, objectives of the course.
Review of the training curriculum.
10:30-11:30
Lecture 1
Etiology and pathogenesis of HIV infection. ARV drugs.
11:30-11:45
COFFEE BREAK
11:45-12:30
LECTURE 2
HIV Staging. Diagnostic criteria. AIDS case definition.
12:30-13:30
LECTURE 3
Current approaches to management of HIV/AIDS patients. Antiretroviral therapy.
13:30-14:30
LUNCH
14:30-15:15
LECTURE 4
Etiology and pathogenesis of TB.
15:15-16:00
LECTURE 5
TB Classification System. Diagnosis of pulmonary tuberculosis.
16:00-16:15
COFFEE BREAK
16:15-17:00
LECTURE 6
Current approaches to the treatment of pulmonary TB; main anti-TB drugs (according to the WHO Guidelines).
17:00-17:15
Summary of the day
DAY 2
09:00-09:45
LECTURE 7
Team approach in providing care and treatment to patients with TB/HIV co-infection. Roles and responsibilities of care team members.
09:45-10:30
PRACTICAL EXERCISE 1:
How to work effectively as a team. Coordination of HIV/TB activities at the regional level.
10:30-10:45
COFFEE BREAK
10:45-11:30
LECTURE 8
ART in patients with HIV/TB co-infection. Immune reconstitution syndrome and its implications for ART and anti-TB therapy timing.
11:30-12:15
LECTURE 9
Side effects of ART
12:15-13:00
LECTURE 10
Basic principles of counseling. Role of pre- and post-test counseling in detection of TB/HIV co-infection
13:00-14:00
LUNCH
14:00-14:45
LECTURE 11
TB/HIV co-infection. Coordination of HIV/TB activities at the regional level.
14:45-15:15
LECTURE 12
TB and HIV infection. Tuberculosis as HIV-related disease. Clinical symptoms of TB at each stage of HIV disease.
15:15-16:00
PRACTICAL EXERCISE 2
Diagnose pulmonary TB, develop an algorithm for follow-up, and suggest a treatment regimen - for ID specialists
Determine the stage of HIV infection, develop an algorithm for follow-up, and suggest an ART regimen - for TB specialists
16:00-16:15
COFFEE BREAK
16:15-17:00
PRACTICAL EXERCISE 3:
Develop a treatment plan for a patient with HIV/TB co-infection. Review case studies.
17:00-17:15
Summary of the day
DAY 3
09:00-10:00
LECTURE 13
Adherence promotion and monitoring.
10:00-10:45
PRACTICAL EXERCISE 4:
Role-play exercise: Counseling of patients with HIV/TB co-infection on treatment adherence before initiating therapy.
10:45-11:00
COFFEE BREAK
11:00-11:45
LECTURE 14
Treatment monitoring (side effects of ARV and anti-TB drugs, treatment efficacy) in patients treated for both TB and HIV infection.
11:45-13:00
LECTURE 15
General precautions for preventing HIV transmission and procedures for PEP.
13:00-14:00
LUNCH
14:00-14:45
LECTURE 16
TB detection. The role of the tuberculin skin test in the diagnosis of TB. Latent TB infection. Chemoprophylaxis for TB in HIV-positive patients. Differentiating latent TB infection from active TB.
14:45-15:15
PRACTICAL EXERCISE 5:
Providing TB chemoprophylaxis in HIV-positive patients based on two case studies (positive skin test without clinical symptoms and positive skin test with clinical symptoms)
15:15-15:30
COFFEE BREAK
15:30-16:15
LECTURE 17
Pulmonary TB: clinical manifestations, diagnosis and treatment of pulmonary TB in HIV-positive patients.
16:15-17:00
LECTURE 18
Differential diagnosis between pulmonary TB and other HIV-related pulmonary diseases. Mixed infection.
17:05-17:15
Summary of the day
DAY 4
09:00-10:00
LECTURE 19
Special considerations for treatment of IDUs with HIV/TB co-infection.
10:00-10:45
LECTURE 20
Special considerations for treatment of pregnant women with HIV/TB co-infection
10:45-11:00
COFFEE BREAK
11:00-12:00
PRACTICAL EXERCISE 6:
Diagnosis and treatment of pulmonary TB for HIV-infected patients. Case studies.
12:00-13:00
LECTURE 21
Prevention of stigma and discrimination.
13:00-14:00
LUNCH
14:00-14:45
LECTURE 22
Extrapulmonary TB in HIV-positive patients. Diagnosis, clinical features, treatment approaches.
14:45-15:15
PRACTICAL EXERCISE 7:
Differential diagnosis and treatment of GI TB in HIV-positive patients. Case studies.
15:15-15:45
PRACTICAL EXERCISE 8:
Case studies on differential diagnosis and treatment of skin and bone TB in HIV-positive patients.
15:45-16:00
COFFEE BREAK
16:00-17:00
PRACTICAL EXERCISE 9:
Case studies on differential diagnosis and treatment of TB meningitis in HIV-positive patients.
17:00-17:15
Summary of the day
DAY 5
09:00-09:45
LECTURE 23
Atypical mycobacteriosis
09:45-10:30
LECTURE 24
Infection control regulations in TB facilities
10:30-10:45
COFFEE BREAK
10:45-11:30
LECTURE 25
WHO guidelines on registration, reporting and referral system for patients with TB/HIV. Monitoring.
11:30-12:15
Breakout group discussion: Coordination of HIV/TB activities at the regional level.
12:15-13:00
Case study presentations and discussions.
13:00-13:30
Post-workshop Questionnaire. Closing remarks.
13:30-14:30
LUNCH