The Impact of HIV Syndromes on the Treatment of TB Cases in Gombe State; Nigeria

ABSTRACT

Tuberculosis (TB) is the leading cause of death among people living with HIV/AIDS worldwide. HIV fuels the TB epidemic in populations such as in Nigeria where there is overlap between those infected with HIV and those infected with Mycobacterium tuberculosis. To address the enormous challenges posed by the dual TB/HIV infection; the Nigerian National Tuberculosis and Leprosy Control Programme (NTBLCP) began collaborative TB/HIV services in Gombe State with some other selected states in 2006. The study looked at 300 new sputum smear-positive acetate-free biofiltration (AFB) patients that had tested positive to HIV screening between diagnosis and second month of follow-up; and were treated between January and December 2006 in the Gombe State TB control programme. The control for the study came from the same cohort of January to December 2006 of new sputum smear-positive AFB patients (595) who had tested negative to HIV screening. The cohort analysis looked at the HIV sero-prevalence and the treatment outcomes: cure rate; failure rate; death rate; default rate; and transfer out rate among new smear pulmonary tuberculosis (PTB) patients that are dually infected with HIV and TB as compared to those not dually infected. The majority of HIV-positive and HIV-negative PTB patients studied were aged 39 years and below. There was no statistically significant difference between the mean age of patients with co-infection and those without co-infection. The majority of the co-infected patients were aged up to 30 years. There was a statistically significant difference in the mean age of males and females. Of the 300 HIV co-infected patients in the study population that were HIV positive; males accounted for 58.3compared with 41.7females. This was not statistically significance. TB patients that were HIV positive had a cure rate of 12.7; while those that were HIV negative had a cure rate of 31.8. The death rate among dually infected patients was higher compared with the HIV-negative patients. The treatment completion and default rates were higher in the HIV co-infected patient