Coronavirus in SA: HIV and TB sufferers not on treatment at high risk

South Africa has a confirmed a few positive cases of the new coronavirus, as health authorities move to contain the spread.

Concerns have previously been raised about the impact of the disease on the South African population as the virus affects those with compromised immune systems much more.

Based on that, Business Insider South Africa recently spoke to a few experts about the possible effects on HIV and tuberculosis patients in the country.

These experts agreed that the compromised immune systems associated with these conditions were of concern, should the virus spread.

Susceptible 

But experts also pointed to the lack of information related to patients with the two diseases, who may have contracted the Covid-19 virus.

“It is [however] not known whether individuals with HIV or TB, both of which are highly prevalent in South Africa, are at increased risk for severe disease following infection with SARS-CoV-2,” the Academy of Science of South Africa told Business Insider South Africa.

Last week Professor Wolfgang Preiser, head of the Division of Medical Virology at the Faculty of Medicine & Health Sciences at Stellenbosch University told Health24: "The places affected so far have a lot less HIV than we have and I have not seen any specific figures for that. However it needs to be assumed (until proven otherwise which is unlikely) that if you have HIV, or TB, or any other chronic illness, your risk of severe coronavirus disease is increased."

This sentiment was further echoed by Professor Keertan Dheda, at the head of the Division of Pulmonology, at the University of Cape Town's Department of Medicine.

"Anyone with underlying immunodeficiency or weakened lung defences will be more susceptible to respiratory pathogens including CV. Thus, individuals who are HIV-infected and those with substantial post-tuberculous lung disease would be more susceptible to contracting coronavirus," Professor Dheda told Health24.

Higher risk

But Professor Ian Sanne, CEO of Right to Care, and a renowned infectious diseases specialist, has warned that specific sufferers of HIV and tuberculosis may be at even higher risk.

In a statement, Professor Sanne cautioned that HIV-positive people and those with tuberculosis who are not on treatment will be at higher risk of worse outcomes if they contract the new coronavirus.

“South Africa has a high rate of people who are HIV-positive and many citizens who suffer from tuberculosis. We are concerned because we do not know how they will respond if they contract Covid-19. There haven’t been sufficient cases of HIV-positive or tuberculosis patients who contracted the virus to determine exactly what the risk is and how they will respond,” he said.

Sanne said people who are HIV positive and on antiretroviral treatment most likely face much less risk. However, patients who are HIV positive and who are not on treatment, with low CD4 counts, will be at increased risk.

Therefore, he said it's even more important to test for your HIV status. "Now is the time to know your status and start treatment.”

He also said that patients who suffer from an existing lung disease such as TB are also at high risk, particularly those who are undiagnosed or not taking medication.

"Tuberculosis sufferers who are on treatment also have lower risk, but they still have to be very careful and should avoid public places, wear masks and wash hands," he added.

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