A Deadly Alliance

BACK in 1959, health workers in the United States predicted that tuberculosis (TB) would soon be eradicated. Indeed, in subsequent years the disease declined so sharply that many people assumed it was under control. But TB is back, and it has found a deadly ally—HIV, the virus that weakens the immune system and usually leads to AIDS.

Although over two billion people—approximately a third of the world’s population—carry TB bacteria, when first infected these people have only a 10-percent lifetime chance of actually contracting the disease. Interestingly, people with HIV have an 8-percent annual risk of developing active TB. As more people contract HIV, therefore, more are in imminent danger of contracting TB.

Dr. Richard J. O’Brien of WHO (World Health Organization) notes that during recent years there has been approximately a 15-percent increase in TB cases in the United States. This, he says, is “largely attributed to the interaction between HIV and TB.” The threat is most serious, however, in the developing world. A full 90 percent of each year’s eight million new cases are found in the poorest countries, and about three million of these patients die.

Worldwide, some 4.4 million people are struggling with the deadly pair. WHO predicts that in the near future, TB will annually take a million lives among those with HIV. “These dual epidemics have together become the most serious public health threat of the decade,” said Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS.

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New Jersey Medical School—National Tuberculosis Center