Cape Town - A UCT study has shown that antiretroviral treatment (ART) reduces the prevalence of tuberculosis in those infected with HIV by more than a third.
UCT researcher Dr Venessa Timmerman and her team discovered, in research they conducted in the Free State, that the treatment reduced the risk of a first TB episode by 36 percent and reduced the risk of getting multiple episodes of TB.
“ART is effective in preventing patients getting TB, therefore if we can treat HIV-positive patients with ART before their immune system is too weakened, which increases their risk of getting TB, it will help reduce the number of people getting TB,” Timmerman said.
The research was carried out in the Free State because of the province’s advanced electronic HIV programme database, which collected patient information before and after ART was started.
This differed from other areas that collected data only once the patient started antiretroviral treatment.
“The massive dataset (collection of units of data) we created from provincial databases made it one of the best representing datasets, which included good and poor performing facilities in the heath system.
“With such a huge sample where multiple facilities are used, it gives statistical power.
“This makes the results more generalisable compared to data from one or two facilities.”
According to her research from all five districts in the Free State, patients accessing ART services at an advanced stage of HIV when they already had a seriously deficient immune system (low CD4 count) would have done much better if they had accessed treatment sooner.
“If a patient can start ART as soon as possible while their CD4 count is still high, it will help the immune system to perform its duties and to fight infections.
“That is the reason why it is so important for patients to know their HIV status and to access the health services provided when they qualify for treatment.”
Timmerman also wants the country to adopt integrated care between ART and TB facilities, as recommended by the World Health Organisation.
“Currently there is a drive towards integrated care in South Africa, but more effort should be made to support and drive this health system integration process.”
More electronic medical record systems in facilities is another prospect that Timmerman hopes will take off.
She said this would help patients know more about their treatment and prognosis. - Cape Argus