The Story of HIV/TB – The Terrible Twins

Year: 2010
Working paper number: 269
Author: Stanwix, Benjamin
Unit: ASRU

The rising incidence of Tuberculosis (TB) in South Africa is closely linked to the rapid spread of HIV/AIDS that has occurred over the last two decades. Compared to other developing countries in this regard South Africa faces a co-epidemic crisis which must be addressed if HIV/TB is to be fought successfully. It is no longer sufficient to focus on each disease separately while neglecting the issues arising from co-infection. When these two diseases intersect it creates serious problems for TB diagnosis and treatment that are not yet adequately dealt with in the existing treatment frameworks. Moreover, TB is the leading cause of death among AIDS sufferers. There is scope for a broader set of TB diagnostic tools to be prescribed, in particular an urgent need for cheap and accurate TB tests to replace the current 120-year-old sputum microscopy. New tests are becoming available but only for a limited group in the private sector. This paper begins by exploring the link between HIV and TB, the data reveals that a change in HIV prevalence is strongly correlated with a change in the incidence of TB. Two techniques are employed to investigate this. The result is an exceptionally high rate of co-infection in countries such as South Africa, where there is high HIV prevalence and high incidence of active and latent TB. The paper then considers why this HIV/TB overlap is such a serious problem for patients and health care workers beyond the problems caused by each disease separately. In conclusion, four broad solutions are examined which would help to address the co-epidemic and solve some of the key problems.

Publication file: WP269.pdf