Avoiding touching eyes, nose, and mouth with unwashed hands. Graphic: Gerd Altmann/Pixabay
Avoiding touching eyes, nose, and mouth with unwashed hands. Graphic: Gerd Altmann/Pixabay

Covid-19: Are TB and HIV patients at higher risk?

By Viwe Ndongeni-Ntlebi Time of article published Mar 18, 2020

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There are 7.7 million people living with HIV in South Africa, of whom over 5.1 million are on antiretroviral therapy (ART), and approximately 600 people are diagnosed with active TB each day in South Africa. 

With the rapidly increasing numbers of people testing positive to the coronavirus (Covid-19) in South Africa: scientists do not know how Covid-19 will affect people with HIV and TB, although they worry that they will be at heightened risk.

The National Institute for Communicable Diseases (NICD) says "there are no data currently available on COVID-19 disease in people living with HIV and/or TB. This may be important since South Africa has a large burden of HIV and TB disease and early reports indicate that people with other comorbid conditions (e.g. cardiovascular disease) or secondary infections have more severe Covid-19 disease and worse outcomes." 

While people of all ages can contract Covid-19, those most at risk of severe complications are older people and those with underlying medical conditions such as lung disease, according to the World Health Organisation (WHO).  

The Academy of Science of South Africa has said that individuals with HIV are already eight times more likely to be admitted to hospital for influenza-linked pneumonia.

However, the organisation says it's important to understand that "since both Covid-19 and TB are transmitted through respiratory secretions there is the possibility that symptomatic individuals with both Covid-19 and TB may transmit TB or Covid-19 more readily. Adherence to preventative measures are therefore important," says NICD.

NICD says available evidence suggests that people with active TB who are infected with influenza may have more severe illness and indicates that a dual infection increases risk.

People with HIV, even those on ART, are at higher risk of developing serious health complications following influenza infection. The risk is especially high in those who have very low CD4+ counts or those who are not taking ART.

"High prevalence of chronic lung damage is well described amongst people previously successfully treated for TB. These individuals have poorer lung function than the general population and are thus at a greater risk for severe disease," says NICD.

South African HIV guidelines encourage all people in South Africa to get tested for HIV, and if positive, to access care and treatment including ART. If you are on ART ensure that you continue to take your medication regularly, remain virally suppressed and stay healthy.

People with HIV and/or TB should practice the same preventative actions that are recommended for everyone. These include:
  • Get the flu vaccine before this flu season, particularly if you are among the recommended groups. Individuals caring for patients are strongly advised to vaccinate.
  • Washing hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitiser.
  • Avoiding touching eyes, nose, and mouth with unwashed hands.
  • Avoiding close contact with people who are sick.
  • Covering coughs or sneezes with a flexed elbow or a tissue, and discard the tissue in the bin.
  • Cleaning and disinfecting frequently touched objects and surfaces.

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