Lockdown: TB & HIV patients who default on treatment are at higher risk for Covid-19

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With high rates of HIV, hypertension, obesity, cardiovascular disease and diabetes, South Africa ticks all the Covid-19 epidemic's risk boxes…

And it's emerged that thousands of tuberculosis (TB) and HIV/Aids patients have not collected their life-saving medication since the lockdown began.

Professor Salim Abdool Karim, the infectious disease specialist who chairs the government's advisory committee on Covid-19, has warned that HIV-positive people and TB patients not on treatment may increase the severity of the virus.

In an oral reply to the Democratic Alliance (DA), Gauteng health MEC Bandile Masuku revealed that since the Covid-19 lockdown restrictions on 27 March, 1,090 tuberculosis patients and 10,950 HIV/Aids patients have not collected their medicine.

The party's spokesperson on health in Gauteng, Jack Bloom, said Masuku revealed this during the virtual sitting of the provincial legislature yesterday. The percentage reduction in chronic medicine collection amounted to 1.4% for TB patients and 19.6% for HIV/Aids patients.

Deteriorating health could lead to greater risk

"These reductions are of concern because interruptions in medicine will lead to health deterioration and drug-resistance for TB and HIV-Aids patients.

"Both these diseases claim a large number of lives – there are about 60,000 TB and 70,000 Aids-related deaths in South Africa every year," Bloom said.

He said extra efforts should be made to trace those who have defaulted on their medicine as well as distribute medicines through additional venues so collection was easier at this time.

Professor Glenda Davison, head of the Biomedical Sciences Department at Cape Peninsula University of Technology and honorary senior lecturer at the University of Cape Town, said this was worrying as it could have devastating effects.

"That could have consequences (because) if patients don't stay on their ARV treatment, their CD4 (white blood cells) counts will slowly drop and they will become immuno-compromised.

"That not only predisposes them to Covid-19, but other infections as well," she said.

South Africa has the biggest HIV epidemic in the world, with 7.7 million people living with HIV, with Davison stressing the need to tread cautiously.

She said that SA might have the opportunity to provide the rest of the world with knowledge in the area of how HIV and Covid-19 interact.

"There is very little information on HIV and Covid-19, and the studies which have been published are on very small numbers of patients."

She said evidence suggest that patients on anti-retroviral (ARV) treatment were not more at risk of contracting Covid-19.

The concern was the HIV-positive individuals not on treatment, who have low CD4 counts and other co-morbidities such as diabetes and hypertension.

"This group is probably immuno-compromised and are at higher risk of both infection and a more severe clinical course."

She added that SA had a very high rate of obesity, cardiovascular disease and diabetes.

"In these disorders the immune system is abnormal and dysfunctional."

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siphom@citizen.co.za

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Sipho Mabena – Citizen

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