Assessment of HIV-TB co-infection in newly diagnosed HIV positive patients and their correlation with CD4 and viral load

Background: Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) constitute a major burden of infectious diseases in India. TB is the most common opportunistic infection and a leading cause of death among HIV positive patients. This study was conducted to assess the HIV–TB co-infection in newly diagnosed HIV patients and correlate co-infection with CD4 and viral load (VL). Methods: A prospective observational study was carried out from January 2021 to June 2022 at ART center of a tertiary care hospital. Screening for TB was done by GeneXpert and Radiology. These patients were monitored for absolute CD4 count by flow cytometer and VL by Real time PCR. Results: Among 380 newly diagnosed HIV patients screened, 94 (24.70%) had HIV-TB coinfection. Of these, 42 (44.6%) were pulmonary tuberculosis (PTB) and 52 (55.3%) were extrapulmonary tuberculosis (EPTB) of 42 patients with PTB, 31 (73.80%) were microbiologically confirmed by GeneXpert whereas of 52 patients with EPTB, 33 (63.46%) were diagnosed clinically and radio-logically. Of 94 patients, only 55 patients could be followed up further at 6 months. Of 55 patients, 33 (60%) had CD4 count <350 cells/mm3 and 2 (3.6%) had baseline VL?1000 copies/ml. 46.80% patients completed their anti-tubercular treatment. Conclusions: EPTB was more as compared to PTB. Co-infection was more with low CD4 counts. Hence, CD4 test can be used as a good immunological marker in co-infection. The study highlights the need of periodic screening of newly diagnosed HIV patients for TB and their monitoring for CD4 and VL.