A HOSPITAL BASED OBSERVATIONAL STUDY ON HIV-TB COINFECTION

ABSTRACT     BACKGROUND: Human immunodeficiency virus (HIV) is the major cause of failure to reach targets of tuberculosis (TB) control in settings with high HIV load. TB on the other hand enhances the progression of HIV infection to acquired immunodeficiency syndrome (AIDS). METHODOLOGY: An observational study was conducted in which 573 patients who were newly diagnosed with HIV infection and enrolled at an antiretroviral therapy (ART) center, King Georges Medical University (KGMU), Lucknow between May 2021 to June 2022 were taken, of which 80 patients had newly diagnosed TB. These HIV-TB co-infected patients were analyzed for demographic factors. Also, clusters of differentiation 4 (CD4) counts were done at the time of enrolment on ART and then about six to eight months later. For comparison, of the 493 HIV-only patients, 50 age and sex-matched consecutive patients for whom both the baseline and follow-up CD4 counts were available and were not investigated for tuberculosis during the study period were enrolled as controls. The change from baseline CD4 count was calculated with the use of paired t-test and Wilcoxon signed rank test. RESULTS : In the present study, among HIV-TB coinfected patients, baseline CD4 levels were 194.52±162.27, and follow-up CD4 levels were 285.09±170.33. An increment of 90.57±165.60 in mean CD4 levels was observed which was statistically significant(t=4.019; p<0.001 ). Likewise, in only HIV-positive patients a statistically significant increment of 125.26±191.48 (35.75%) cells in mean CD4 levels was observed (t=4.626; p<0.001). CONCLUSION : A significant rise in CD4 counts was observed in both HIV-TB coinfected patients started on ART plus anti-tubercular treatment (ATT) and HIV-only patients started on ART. Still, the rise is significantly higher among the HIV-only group as compared to the HIV-TB co-positive group.