AEGiS-WSJ: WHO Stresses TB-HIV Link

Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.

WHO Stresses TB-HIV Link

Wall Street Journal - March 25, 2009
Jacob Goldstein

HIV patients accounted for roughly a quarter of people who died from tuberculosis in 2007, according to new World Health Organization estimates that highlight a closer connection between the two diseases than previously known.

New data from the World Health Organization show a closer connection between tuberculosis and HIV than had previously been known. Above, patients wait to see doctors at a TB center in Khayelitsha, South Africa.

In addition, of a total of 9.3 million new TB cases world-wide in 2007, 1.4 million, or 15%, occurred in people infected with HIV, according to the WHO's annual TB report. The overall number of those infected with both diseases is roughly twice as high as found by the United Nations agency in previous years.

The new numbers don't indicate an actual increase in the number of HIV patients dying of TB, or in the overall number of TB cases among HIV patients. Rather, stepped-up HIV testing among TB patients has revealed cases of HIV that previously went undetected.

"We've all suspected that there are huge numbers of people who have HIV and TB," said Wafaa El-Sadr, a professor of medicine and epidemiology at Columbia University in New York. "It demonstrates that one cannot think of tackling or controlling the TB epidemic globally without thinking of how we're going to do it in HIV-infected populations."

TB is a bacterial infection that typically affects the lungs. It usually can be treated with widely available drugs and has been largely eliminated as a cause of death in wealthy countries. But it continues to be a scourge in much of the developing world, contributing to the deaths of an estimated 1.8 million people a year.

HIV, the virus that causes AIDS, attacks the immune system, leaving patients vulnerable to many types of infections. Being infected with HIV can increase the risk of getting TB by a factor of 20 or more, the WHO says.

Previously, WHO estimates of patients infected with both diseases used data from 15 countries. The latest figures are from 64 countries, including several in sub-Saharan Africa, home to most of the patients infected with both diseases. The report notes better data are still needed "to increase the reliability of these estimates."

Write to Jacob Goldstein at jacob.goldstein@wsj.com

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