Virtual symposium by the iPVD Consortium: Microbes series – Bacteria

Date: May 29, 2024

Unveiling the burden: Post-tuberculosis PVD in South Africa
Dr. Friedrich Thienemann (University of Cape Town, South Africa/University of Zurich, Switzerland)

Summary:

• Tuberculosis (TB) remains a major global infectious disease threat, with 10 million cases annually and high mortality, especially in low- and middle-income countries like South Africa.
• Social determinants of health—including poverty, hunger, illiteracy, and access to healthcare—strongly influence TB burden and outcomes. South Africa and surrounding regions have the highest TB case notification rates globally, fueled by HIV co-infection and dense, impoverished living conditions.
• TB can affect the entire heart axis, causing complications such as pericarditis and pulmonary hypertension (PH), especially post-TB. Post-TB syndrome includes persistent lung damage and symptoms; TB survivors face significantly higher long-term mortality and increased cardiovascular risks.
• Studies show elevated prevalence of PH in post-TB patients, ranging from 6% in apparently healthy individuals to over 40% in symptomatic post-TB patients. Current diagnostic tools like six-minute walk tests are insufficient for screening post-TB PH; echocardiography and right heart catheterization access is limited in high-burden areas.
• Ongoing research includes advanced imaging (PET-CT, cardiac MRI) and clinical trials (e.g., atorvastatin to reduce inflammation) to understand and treat post-TB lung and cardiovascular complications.
• Efforts focus on cohort establishment, improved diagnostics, understanding immunological mechanisms, and developing treatment guidelines tailored to resource-limited settings.
• The multidisciplinary team works collaboratively with local and international partners to advance research, clinical care, and public health interventions targeting TB-associated pulmonary vascular disease.