A Cross Sectional Study on Impact of Anti Tuberculosis Treatment in Tuberculosis (TB) Human Immunodeficiency Virus (HIV) Co-Infection

ABSTRACT

Introduction: TB is the most common opportunistic infection in HIV positive people. HIV-TB co-infection is a fatal combination with higher death rates in developing countries. In cured TB cases in HIV positive people, chances of recurrent also high. ART prevents the progression of HIV, reduces the chances of another opportunistic infection that could make management of care more complicated, and reduces the chances of TB recurring. Objectives: To document the profile of HIV positive TB patients availing both Anti-Retroviral (ART) and Anti Koch's Treatment (AKT) at a tertiary care hospital. Method: A retrospective descriptive study was conducted using available records of 198 HIV positive TB patients enrolled at an ART Centre of South Gujarat from November 2016 to November 2017. Age at enrollment at ART Centre, sex, native place, ART status, CD4 count were recorded along with detection, category, previous history and treatment of TB. Test of significance (t test) was applied to analyze the difference between CD4 count before and after treatment with AKT. Results: Mean age of male (n=123) and female (n=75) patients at the time of HIV detection was mean 37.62 (SD±11.61) years and mean 34.05 (SD±8.85) years respectively. Majority (86.87 %) were migrants from states other than Gujarat, of which 31.31% were from Maharashtra. Among them, 66% patients were on CAT-I AKT and 10.6% had previous history of TB. Among 56.1% patients who had extra-pulmonary TB, common were abdominal TB (47.75%), lymphadenopathy (18.02%) and pleural effusion (16.22%). While 32% of patients had completed their AKT regimen, 68% were on AKT. Among those were missed out (8.6%) and lost to follow up (3.5%) from ART, almost half (41.67%) had been initiated under CAT-II AKT. Mean CD4 count for 84 patients who completed their AKT was increase, this was statistically significant (p=0.001). Conclusion: Majority of patients were migrants and extra pulmonary TB was more common in this study group. Mean CD4 count increased significantly after completion of AKT. Prompt treatment and preventing loss to follow up are key to successful treatment completion and cure.