HIV and Oral Health: Tuberculosis Diagnosis in People with HIV Increases Risk of Death Within 10 Years
By: Mark Schweizer, DDS MPH
Director of Development and Special Projects
Dental Director Southeastern AIDS Training and Education Center
Nova Southeastern University College of Dental Medicine
[email protected]
People with HIV are at greater risk of TB disease than HIV-negative people without HIV due to HIV-related immune system damage as well as geographical and behavioral risk factors shared by both diseases. In 2017, the World Health Organization estimates there were 920,000 new TB cases among individuals with HIV globally, and approximately 300,000 people with HIV died from TB. Due to this large burden of HIV and TB co-infection, NIAID supports research to improve TB prevention, diagnosis, and treatment in the context of HIV infection.
“Tuberculosis remains the leading cause of death for people with HIV globally,” said NIAID Director Anthony S. Fauci, M.D. “This new analysis shows how devastating TB can be for people with HIV and underscores the need to do more to prevent and treat this co-infection.”
Investigators analyzed the clinical records of 15,999 people with HIV who received care in CCASAnet clinics in Brazil, Chile, Haiti, Honduras, Mexico and Peru. Each participant remained in care for at least 9 months after their first clinic visit; they had not received antiretroviral drugs to treat HIV infection before arriving at the clinic.
Researchers found that 1,051 individuals — nearly 7 percent — were diagnosed with TB during their first visit and were prescribed anti-TB and HIV medications. After 5 years of observation, approximately 10 percent of patients with TB had died, compared with fewer than 6 percent of those without TB at their initial visit. This pattern continued: after 10 years of observation, more than 19 percent of the group initially diagnosed with TB had died, compared with 10.5 percent of the group without an initial TB diagnosis. Investigators measured 5- and 10-year survival rates beginning at 9 months after each patient’s initial clinic visit, at which time most people recover from TB with standard treatment.
