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WHO increases estimated numbers of TB deaths associated with HIV

The World Health Organization said this week that more than 450 000 of the people who died from tuberculosis in 2007 were infected with HIV, more than double the estimated global total of 200 000 in 2006.

Writing in the British Medical Journal John Zarocostas said that the WHO attributed the increase mainly to a big rise in testing for HIV among people being treated for tuberculosis, particularly in Africa.

"These findings point to an urgent need . . . to test for HIV in all patients with TB in order to provide prevention, treatment, and care," said Margaret Chan, WHO's director general.

"Countries can only do that through stronger collaboration programmes and stronger health systems that address both diseases," Dr Chan said.

The new expert report from WHO says, "HIV-positive people are about 20 times more likely than HIV-negative people to develop TB in countries with a generalized HIV epidemic (compared with a previous estimate of six)." The new data are direct measurements in 64 countries of the proportion of people with tuberculosis who are also infected with HIV.

"It's an upgrading of the TB data [that is] based on better methodologies, more data, and more HIV testing," said Kevin DeCock, WHO's director for HIV.

In 2007 about 37% of patients with tuberculosis in WHO's African region were tested for HIV, up from 4% in 2004 and from 22% in 2006, says the report.

It says that in 2007 an estimated 9.27 million new cases of tuberculosis were recorded worldwide and about 1.75 million people died from the disease.

The African region accounted for most of the world's HIV positive tuberculosis patients (79%), followed by the South East Asia region (mainly India), with about 11% of the total.

Global Tuberculosis Control: Surveillance, Planning, Financing is available at www.who.int/tb.

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