Characterising and addressing cachexia in people with TB

Speaker: Angus is a medical doctor and Global Health Research Fellow at the Elizabeth Blackwell Institute, University of Bristol currently working at The Health Research Unit, Zimbabwe (THRU-ZIM). His research focuses on how infections affect the musculoskeletal system, with a particular interest in cachexia—the severe muscle wasting that can occur in people with tuberculosis (TB). Angus first became interested in this field while working with Médecins Sans Frontières (MSF) in India, where he worked on a project focused on caring for people with advanced HIV. There, he observed that those with severe wasting faced longer, more complicated recoveries and often returned to the hospital months later with secondary complications, immobility and disability.

Topic: Cachexia is “a multifactorial metabolic condition characterized by ongoing loss of skeletal muscle mass (sometimes with fat loss) that cannot be fully reversed by nutritional support alone and leads to functional impairment.” Tuberculosis is frequently cited as a cause of cachexia, yet little is known about this phenomenon in people with TB — including whether it represents a distinct entity from malnutrition and whether this distinction has clinical significance.

Angus has led a scoping review on cachexia and skeletal muscle involvement in TB and currently co-leads a cohort study investigating the impact of TB on the musculoskeletal system in Zimbabwe. Early findings suggest that cachexia in TB is poorly understood and that muscle wasting may contribute to functional impairment. Recovery after TB treatment appears to be incomplete in some individuals, potentially leading to long-term morbidity that remains under-characterized.