Covid-19: Preliminary study indicates that HIV and TB have a modest effect on mortality in SA

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Prof. Salim  Abdool Karim
Prof. Salim Abdool Karim
City Press
  • Preliminary results of just over 12 000 Covid-19 patients in SA indicate that HIV and TB have a modest effect on Covid-19 mortality.
  • 12% and 2% of Covid-19 deaths are attributable to HIV and TB, respectively.
  • An early response to Covid-19 by government has had an impact on HIV and TB when it comes to patients defaulting on medications.

Preliminary results from a study of 12 987 Covid-19 patients in South Africa indicate that HIV and TB have a modest effect on mortality, lead scientists Professor Quarraisha Abdool Karim and Professor Salim Abdool Karim said.

"The biological and epidemiological interaction of Covid-19, HIV and TB is not well understood," they said.

"Patients immunocompromised by HIV or with TB lung disease could be more susceptible to severe Covid-19. However, preliminary results from a study of 12 987 Covid-19 patients in South Africa indicate that HIV and TB have a modest effect on Covid-19 mortality".

Professor Quarraisha Abdool Karim, associate scientific director of the Centre for the Aids Programme of Research in South Africa (CAPRISA) and Professor Salim Abdool Karim, a clinical infectious diseases epidemiologist, shared this insight in an article titled "Covid-19 affects HIV and tuberculosis care" in Sciencemag on 24 July 2020.

The article delves into how South Africa's TB and HIV infrastructure helped the rapid response to Covid-19 and the impact this has had on these conditions.

READ | People living with HIV, TB at 2- to 3-fold higher risk of Covid-19 death

The two scientists added that the preliminary results indicated that, of the group tested, 12% and 2% of Covid-19 deaths were attributable to HIV and TB respectively, compared to 52% of Covid-19 deaths attributable to diabetes.

Quarraisha Abdool Karim
Quarraisha Abdool Karim.

"The small contribution of HIV and TB to Covid-19 mortality is mainly due to these deaths occurring in older people, in whom HIV and active TB are not common.

"Integrated medical care for these three conditions is important as Covid-19 patients coinfected with HIV or TB start attending health care services in larger numbers," they explained.

While South Africa's experience in dealing with the HIV and TB epidemics has laid the foundations for the country's rapid and early community-based response to Covid-19, it has had an impact on those very conditions.

ALSO READ | TB, HIV patients defaulting on medication during lockdown, says Gauteng health dept

The scientists cite that access to medical care for non–Covid-19 conditions was limited during the lockdown, with health facilities experiencing declines in the number of TB and HIV patients collecting their medication on schedule.

"The World Health Organisation estimates that a six-month disruption of antiretroviral therapy could lead to more than 500 000 additional deaths from Aids-related illness in 2021 and a reversal of gains made in the prevention of mother-to-child transmission.

"In South Africa, 1 090 TB patients and 10 950 HIV patients in one province have not collected their medications on schedule since the start of the national lockdown," the scientists further said.

News24 earlier reported that the Gauteng Department of Health recorded that 1 090 patients had failed to collect their TB medication and that 10 950 had failed to collect their antiretroviral medicines since the lockdown was implemented in March.

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