What’s the link between HIV and TB?

There’s a strong connection between HIV/AIDS and TB, predominantly in South Africa. Here’s why:

HIV and TB: The connection.

Is the HIV/TB connection different in South Africa?

Medical staff across South Africa automatically test for Tuberculosis and HIV at the same time, and for good reason. The prevalence of HIV and TB is extremely high in South Africa. Every effort must be made to accurately diagnose patients, before educating and treating them appropriately.

What is HIV?

The Human Immunodeficiency Virus (HIV) is spread from person to person through the exchange of bodily fluids. If you are infected with HIV, the virus attacks your body’s white blood cells, also known as CD4 cells or T cells. Over time, the virus destroys more cells, reducing your body’s ability to fight off infections and other diseases. Your immune system continually weakens, and allowing opportunistic infections to take advantage.

What are the symptoms of HIV?

HIV symptoms vary across the virus’ life inside your body. These range from a light cold to extremely severe symptoms caused by opportunistic infections, like Tuberculosis. Thanks to advancements in medical science, HIV is now a treatable condition.

What is AIDS?

Acquired Immunodeficiency Syndrome (AIDS) is the most advanced stage of HIV infection. As HIV takes its toll on your body’s functioning, twenty or more opportunistic infections (including cancers) take your body’s systems and organs hostage. As your immune system fails to fight off opportunistic infections, your health deteriorates at an increasing pace. This eventually leads to you succumbing to a multitude of ailments.

How is HIV treated?

Access to antiretroviral treatment (ARVs) has become crucial in South Africa. Getting tested has never been more important for taking control of your life. Medical staff are trained at length on how to cope with HIV: medically, mentally, emotionally, and spiritually. The quicker you move onto a treatment plan, and the more disciplined you are about sticking to it, the better your chances of living a long and healthy life.

What is TB?

Tuberculosis (TB) mainly affects your lungs (pulmonary TB), but can be found in almost any other organ. It can be contracted through the sneeze, cough or sputum (spit) of an infected person. Contracting TB doesn’t necessarily mean you will develop and display its symptoms. Although it’s highly contagious, you may not even know you’ve contracted it.

What is latent TB?

Latent TB occurs when TB bacteria remain dormant in your system. Symptoms don’t appear, and life continues as normal. An estimated 80% of South Africa’s population has latent TB, and will never experience symptoms. Sadly, people with suppressed immune systems are not as lucky. HIV patients fall into the more at-risk bracket. A suppressed immune system nearly guarantees that every opportunistic infection will result in symptomatic display, especially if HIV treatment is not adhered to.

What causes TB?

Unlike HIV, TB is a bacterial infection. Mycobacterium Tuberculosis, the bacteria, are contained in the bodily fluids primarily associated with spitting, coughing and sneezing. The bacteria settle in to destroy the soft tissue in your lungs. This leads to the development of holes in your lungs, making it really difficult for you to breathe normally. Just like HIV treatment, though, TB treatment has advanced over the years.

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HIV/AIDS and TB statistics in South Africa:

  • During 2017, more than 300 000 individuals were diagnosed and treated for TB in South Africa.
  • Just over 60% of those individuals were also HIV-positive.

How are HIV and TB connected?

TB is considered one of the most prevalent opportunistic infections to affect HIV patients in South Africa. Any HIV patient not actively adhering to ARV treatment is highly susceptible to the onset and severe symptomatic display of TB. An HIV-negative TB patient is far less likely to experience symptoms because of an uncompromised immune system.

How are HIV and TB specifically connected in South Africa?

South Africa ranks sixth in the world for the highest infection rate of TB. TB prevalence is most extreme in densely populated areas lacking access to sewerage, drainage and service delivery: informal settlements. With staggering numbers of community members still trying to survive in such conditions, most HIV healthcare programmes also cater for TB treatment.

Joint treatment for HIV and TB

If you’re diagnosed as both HIV-positive and a TB patient, you’ll immediately begin a ‘co-infection programme’. Treatment adherence is of utmost importance in such a situation, because both HIV and TB infections need to be treated simultaneously. Medications cause chemical reactions that must be closely monitored and carefully managed.

What happens if you don’t take your HIV/TB medicine on time?

Taking the right medication in the correct order at the correct times is critical for successfully completing a co-infection programme. TB can very quickly become resistant to drugs if given the smallest opportunity (e.g. taking your medication two hours late). Neglecting your treatment regimen can have devastating effects in a situation where HIV is also present in the body. When someone talks about treatment adherence, it means that you must stick to the exact guidelines around when and how to take your medication. This is extremely important and should become an essential part of your daily routine.

How does AllLife help HIV-positive people stay healthy?

At AllLife, we help you stick to your treatment and checkup plans, by sending you regular reminders about your medication and when to attend your next medical appointment.

What is XDR-TB?

Failing to stick to a treatment plan often results in something called Extensively Drug Resistant Tuberculosis (XDR-TB). Regular medication no longer works; bacteria mutate and develop their own immunity to antibiotics. For TB to be passed along or contracted after this evolution has occurred, can be deadly. It’s so severe that a second layer needs to be added onto the treatment plan to give you a fighting chance to overcome it. It takes much longer to diagnose and confirm the bacterial resistance, also known as XDR-TB.

A regular TB treatment plan can take approximately six months to complete, but an XDR-TB plan needs to be at least 18 months, or longer. 

How long can people live with HIV and TB?

Being HIV-positive is no longer as scary as it used to be. Thanks to science and technology, you can live a long, happy and healthy life as an HIV patient. Every year, major breakthroughs are constantly being reported, inspiring hope across the world for an HIV vaccine to soon be developed.


Alexander, M. 2018. Infographic: HIV and Aids in South Africa 1990 to 2016. 14 April. Available at: https://southafrica-info.com/infographics/infographic-hiv-aids-south-africa-1990-2016/ [Accessed 18 July 2019].

Avert. 2019. HIV and AIDS in South Africa. 18 January. Available at: https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa [Accessed 18 July 2019].

Avert. 2019. HIV and Tuberculosis co-infection programmes. 26 June. Available at: https://www.avert.org/professionals/hiv-programming/hiv-tb-coinfection [Accessed 18 July 2019].

Avert. 2019. What are HIV and AIDS. 4 April. Available at: https://www.avert.org/about-hiv-aids/what-hiv-aids [Accessed 18 July 2019].

Centers for Disease Control and Prevention. 2011. Integrating Prevention, Treatment and Care Services. 5 December. Available at: https://www.cdc.gov/globalhealth/countries/southafrica/what/tb_hiv.htm [Accessed 18 July 2019].

Centers for Disease Control and Prevention. 2016. Extensively Drug-Resistant Tuberculosis (XDR TB). 4 May. Available at: https://www.cdc.gov/tb/publications/factsheets/drtb/xdrtb.htm [Accessed 22 July 2019].

Dawood, H. n.d.. Management of HIV and TB co-infection in South Africa. Available at: http://www.kznhealth.gov.za/medicine/presentation27.pdf. [Accessed 22 July 2019].

Kwazulu Natal Department of Health. 2019. Tuberculosis (TB). Available at: http://www.kznhealth.gov.za/tb.htm [Accessed 18 July 2019].

Planned Parenthood. 2019. HIV & AIDS. Available at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids [Accessed 18 July 2019].

South African Government Website. 2017. World TB Day 2018. 30 November. Available at: https://www.gov.za/speeches/world-tb-day-2018-30-nov-2017-1109 [Accessed 18 July 2019].

TB Facts. 2019. TB disease, symptoms, treatment, drugs, drug resistance. Available at: https://www.tbfacts.org/tb/ [Accessed 18 July 2019].

United States Department of Health and Human Services. n.d. What Are HIV and AIDS? Available at: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids [Accessed 18 July 2019].

United States Department of Health and Human Services. n.d. Global Statistics. Available at: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics [Accessed 18 July 2019].

Van Der Merwe, M. 2016. The Daily Maverick. Analysis: Tackling the deadly duo of TB and HIV/Aids in South Africa. 18 August. Available at: https://www.dailymaverick.co.za/article/2016-08-18-analysis-tackling-the-deadly-duo-of-tb-and-hivaids-in-south-africa/ [Accessed 18 July 2019].

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