News
HST Collects relevant news from a variety of sources, for your convenience. Select a story from below, or use our search feature to find stories of interest.

HIV leads to rise in TB incidence in both HIV-positive and HIV-negative SA gold miners
Michael Carter
2004-03-11

HIV has led to an increase in new tuberculosis (TB) infections not only in individuals with HIV, but also in HIV-negative individuals, according to a cohort study involving South African gold miners published in the March 5th edition of AIDS.

HIV has led to an increase in new tuberculosis (TB) infections not only in individuals with HIV, but also in HIV-negative individuals, according to a cohort study involving South African gold miners published in the March 5th edition of AIDS. 

The findings of this study stand in contrast to a similar study published last year which was conducted in three South African gold mines and found a stable incidence of TB amongst HIV-negative miners despite huge increases in incidence of TB amongst their HIV-positive colleagues (see link below). 

The newly published retrospective cohort study was conducted in four South African gold mines between 1991 and 1997 and involved 27, 874 individuals whose HIV status was known. 

A total of 3, 371 miners were infected with HIV at entry to the study, and a further 2, 737 tested HIV-positive during the study period. 

Annual chest X-rays were used to screen for TB, but contract tracing and presentation with symptomatic TB disease also contributed TB case reports. All miners from four mines undergoing HIV between 1991 and 1997 were included in the study, however individuals with a past-history of TB were excluded. No patient received either antiretroviral therapy for TB or isoniazid prophylaxis for TB during the course of the study. 

The incidence of new TB cases increased dramatically at the four mines between 1991 and 1997 from 0.53% to 1%, with preliminary data showing that this incidence continued to increase to 1.2% in 1998 and 2% in 2000. In addition, the investigators found that the proportion of TB cases involving HIV-positive individuals increased from 10% in 1991 to 64% in 1997. 

It was also established that TB incidence increased in HIV-negative miners from 0.50% in 1991 – 92, to 1.28% in 1995 – 97. During this period TB incidence in HIV-positive individuals increased to 3% per year. 

TB incidence also increased with age (incidence risk ratio [IRR] for under 30s of 1, increasing to 4.8 for over 50s), but even after adjustment for increasing age, the investigators still found that the annual incidence of TB in both HIV-positive and HIV-negative miners increased over time (p<0.001). 

Furthermore, the investigators found that the proportion of TB cases attributable to HIV increased from zero in 1991 to 41% in 1997. 

”In this population we have demonstrated an increase in the incidence of tuberculosis during a period of rapidly rising HIV prevalence”, comment the investigators, who note that TB incidence increased not only in HIV-positive miners but also in HIV-negative individuals. “The increased incidence of tuberculosis in HIV-negative miners is likely to be caused by onward transmission from the increased number of (mainly HIV-positive) tuberculosis cases.” 

The investigators warn that even in mines, where there is active TB case finding, good diagnostic techniques, and treatment outcome is above the target set by the World Health Organisation, the “effect of HIV on the incidence of tuberculosis cannot be adequately contained.” 

Ref: Sonnenberg P et al. HIV and pulmonary tuberculosis: the impact goes beyond those infected with HIV. AIDS 18: 657 - 662, 2004 . Related Link: http://www.aidsmap.com/news/newsdisplay2.asp?newsId=2351( Source: AIDSMAP 9 March 2004 ).

Keywords	This Item is associated with the Following Keywords: .
You Can Comment on this Item, or View other people's Comments
Easy Print  Email to a friend

	Related News
	Despite high rates of TB in HIV-positives, TB rates stable in HIV-negative S Africans with TB (2003-10-16) Risk of TB doubles in first year of HIV infection (2005-01-07) HIV treatment reduces risk of TB in South Africa more than previously thought (2005-12-14) HAART means that HIV-positive patients much less likely to be hospitalised with flu (2003-11-12) Failure of three main classes of antiretrovirals present in 12% of EuroSIDA cohort (2004-11-17)

	Related Publications
	Rapid Increase in Tuberculosis Incidence Soon after Infection with HIVA New Twist in the Twin Epidemics (2005-05-19) How Soon after Infection with HIV Does the Risk of Tuberculosis Start to Increase? A Retrospective Cohort Study in South African Gold Miners (2005-05-19) The Demographic Impact of HIV/AIDS in South Africa - National Indicators for 2004 (2005-01-27) WHO report 2005 - Global tuberculosis control: surveillance, planning, financing (2005-03-24) Tackling TB in Benede Oranje Region (2000-06-15)

	Related Health Statistics
	Incidence of TB (PTB new Sm+) (per 100 000) (2005-05-25) HIV incidence (2005-04-20) Male urethral discharge incidence (0000-00-00) Proportion of extra-pulmonary TB (2005-05-25) Incidence of TB (all types) (per 100 000) (2005-05-25)

	Related Events
	Women's Health - Cervical Cancer Awareness Month (2007-09-01) Invitation to the launch of The Cholera Outbreak report (2002-03-25) Impumelelo Innovations Award Trust HIV/AIDS Workshop (2008-09-11) Interactions Between Poverty and HIV/AIDS (2005-12-12) International HIV/AIDS Treatment Education and Advocacy Summit (2000-03-13)

	Related links
	Self Study Modules on Tuberculosis South African Demographic and Health Survey 1998. Preliminary Report AfroAIDSinfo Directory of Open Access Journals Aidsmap

	Related Content
	ISDS Site: uMkhanyakude District Municipality (2004-05-10) Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTCT) (2004-04-07) Research: Health Systems Research (2007-08-06) Research: Tuberculosis Research (2007-08-06) District Health and Local Government (2004-04-07)