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​Researchers from the Wits Reproductive Health & HIV Institute (WRHI) in Johannesburg, South Africa, in the first pathological study to address why HIV patients on antiretroviral therapy die, have learned that the vast majority of deaths are due to tuberculosis (TB).  During the first three months of antiretroviral therapy, when the risk of death is the highest, the team, led by Dr. Emily Wong, found that tuberculosis contributed to at least 80% of the deaths.  Most cases of tuberculosis were undiagnosed and two-thirds were accompanied by at least one other infection or cancer. 

Dr. Francois Venter, the senior author, said of the results, “The TB finding was scary and its magnitude surprising. What was even more worrying was how secondary infections co-existed in these patients, and often went undiagnosed, even in a hospital setting. The bottom line is that we need better TB prevention and initiation of antiretroviral therapy before people are at risk of these other cancers and infections.”

Dr. Wong is currently an international associate and research fellow at the KwaZulu Research Institute for Tuberculosis and HIV, which officially opened its new research facility on October 9, 2012.  She said, “Despite the roll-out of antiretroviral therapy, HIV and TB continue to be a deadly combination.  The patients and the families who participated in this study wanted good to come from their tragic losses.  We now have a responsibility to understand how these two diseases work together to cause sickness and death so that we can devise better treatments and save lives.”

Causes of Death on Antiretroviral Therapy.pdf