Study of South African Population Reveals the Importance of Screening and Treating for TB in Patients with HIV

A new study reveals that the toll of TB in South Africa is higher than previously thought. End Quote

(1888PressRelease) July 13, 2010 - A large, systematic postmortem study carried out in South Africa by researchers at Brigham and Women's Hospital (BWH) has revealed that 94 percent of deceased patients were HIV infected and 50 percent had culture-positive tuberculosis (TB) at the time of death. The data reveals that the toll of TB in young people aged 20 to 45, in Kwa Zulu Natal is higher than previously thought. These findings are published in PLoS Medicine on June 22, 2010.

Every year, nearly 10 million people develop TB-a contagious bacterial infection that affects the lungs and other parts of the body, caused by Mycobacterium TB -and nearly two million people die from the disease.

People who are infected with HIV, the virus that causes AIDS, are particularly susceptible to TB because of their weakened immune system. Postmortem studies which assess contributory causes of death in patients admitted to hospital in an area where mortality from TB and TB/HIV is extremely high are infrequently done, but provide key data that can enable optimization of HIV and TB treatment programs.

The researchers, lead by Ted Cohen, MD, MPH, DrPh, Assistant Professor in Medicine in the Division of Global Health Equity BWH, determined the prevalence and drug sensitivity of TB among patients dying in a public hospital in KwaZulu-Natal, South Africa.

The authors found that the majority of the deceased, who at the time of death were receiving TB treatment, were infected Mycobacterium TB strains that were fully susceptible to antibiotics. This suggests that the diagnosis of TB was made too late to alter the fatal course of the infection.

These findings suggest that improving the early diagnosis of TB, for example, routine screening for tuberculosis among HIV-positive patients, and speedier initiation of treatment for both tuberculosis and HIV could reduce the global death toll from TB.

Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit http://www.brighamandwomens.org/.

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