UVA researchers help identify TB as major cause of sepsis

A first-of-its-kind study found tuberculosis is a leading cause of sepsis in HIV patients in Africa

Jan. 31, 2026 at 8:15am

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Researchers from the University of Virginia School of Medicine collaborated with researchers from other American universities and in Africa on the ATLAS Study, which found that tuberculosis (TB) is a major cause of sepsis in HIV patients in Tanzania and Uganda. The study concluded that immediately treating patients for TB, even before a diagnosis, could be life-saving, as current guidelines only call for TB treatment after diagnosis, which is often delayed in the region due to limited access to sophisticated blood tests.

Why it matters

Sepsis is a leading cause of death worldwide, and those with HIV are particularly at risk. Previously, the cause of sepsis in these regions was often unknown or attributed to other infections. This study provides evidence that treating TB, a treatable infection, could significantly improve survival rates for sepsis patients in TB-endemic areas.

The details

The ATLAS Study, conducted over five years at hospitals in Tanzania and Uganda, evaluated over 400 patients and found that more than half had TB. The study concluded that immediate treatment of TB, even before a sepsis diagnosis, could be life-saving, as current guidelines only call for TB treatment after diagnosis, which is often delayed in the region due to limited access to sophisticated blood tests. Researchers believe TB often goes unrecognized as a cause of sepsis due to the difficulty of diagnosing the disease in East Africa.

  • The ATLAS Study was conducted over the course of five years.
  • The study results have already been published in two open access scientific journals — Lancet Infectious Diseases and eClinicalMedicine.

The players

UVA School of Medicine

The University of Virginia School of Medicine contributed researchers to the ATLAS Study.

Tulane School of Medicine

Researchers from the Tulane School of Medicine were also part of the ATLAS Study collaboration.

University of Minnesota

Researchers from the University of Minnesota were also part of the ATLAS Study collaboration.

Stellah Mpagama

A leading HIV and tuberculosis physician-scientist from Tanzania's Kibong'oto Infectious Diseases Hospital who collaborated on the ATLAS Study.

Conrad Muzoora

A leading HIV and tuberculosis physician-scientist from Uganda's Mbarara University of Science and Technology who collaborated on the ATLAS Study.

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What they’re saying

“In life-threatening sepsis in other parts of the world, a germ causing infection is either not found or is commonly caused by bacteria from urinary tract infections or pneumonia. Instead, we found a treatable form of infection in the majority of people that could be targeted immediately when they presented to care.”

— Dr. Scott Heysell, UVA Health researcher and co-leader of the ATLAS Study

“This study has the potential to provide a blueprint for evidence-based antimicrobial approach for sepsis therapy in TB-endemic areas. My hope is that this work will help lower the extremely high mortality of patients with TB-sepsis.”

— Dr. Eva Otoupalova, Tulane researcher

What’s next

The study results have already been published in two open access scientific journals, and researchers hope the findings will lead to changes in treatment guidelines to allow for immediate TB treatment for sepsis patients, even before a diagnosis, in order to save lives in TB-endemic regions.

The takeaway

This groundbreaking study provides critical evidence that tuberculosis is a major, yet previously unrecognized, cause of sepsis in HIV patients in Africa. By identifying this treatable infection as a leading driver of this deadly condition, researchers believe lives can be saved through immediate TB treatment, even before a formal diagnosis is made.