Study: Depo-Provera increases risk of TB
THE common injectable contraceptive used by most women has now been found to increase women’s chances of contracting tuberculosis (TB).
This is according to a study by Professor Keertan Dheda and Dr Michele Tomasicchio at UCT’s Centre for Lung Infection and Immunity.
Injectable contraceptives are widely used across sub-Saharan Africa, being the birth control method of choice for about 16.5million women in the region. A recent meta-analysis of clinical observational data suggested that Depo-Provera may increase women’s chances of contracting HIV by up to 40%.
This is because the injection contains the synthetic hormone medroxyprogesterone acetate (MPA), which acts as an immunosuppressant.
Considering the prevalence of TB in sub-Saharan Africa, and the fact that it remains the top infectious disease killer globally, Tomasicchio said he realised the necessity of investigating whether the use of Depo-Provera could also increase the risk of TB infection.
“We looked at two different injectable contraceptives that are commonly used in South Africa – Depo-Provera and norethisterone enanthate (NET-EN). Our data showed that Depo-Provera increases TB pathogenesis, while NET does not.”
“Depo-Provera actually downregulates immune function genes associated with protection against TB, and also up-regulates certain cell types that suppress your immune system”
Tomasicchio would like to see the study results drive a change in policy surrounding Depo-Provera usage in South Africa.
“My ultimate aim is to make sure that women are aware of the dangers of using (Depo-Provera), particularly in the context of sub-Saharan Africa,” he said.
“What should happen is government clinics should move over to NET, because it simply is the safer choice.”
Tomasicchio said he planned pursuing this study to gain a better understanding of why and how MPA actually drives TB pathogenesis.
Ultimately, he hopes the mounting evidence will be taken to heart by the South African government and that policy changes will be made sooner rather than later.