Results of tuberculosis treatment in hiv infected patients

Author: 
Roshan Abhinav Mekala and Nalluri Kavya

Tuberculosis (TB) and HIV co-infections place an immense burden on health care systems and pose particular diagnostic and therapeutic challenges. Infection with HIV is the most powerful known risk factor predisposing for Mycobacterium tuberculosis infection and progression to active disease, which increases the risk of latent TB reactivation 20-fold. TB is also the most common cause of AIDS-related death. Thus, M. tuberculosis and HIV act in synergy, accelerating the decline of immunological functions and leading to subsequent death if untreated. The mechanisms behind the breakdown of the immune defense of the co-infected individual are not well known. This is study aimed to assess the outcome of TB treatment and its predictors among HIV infected patients. Medical records of 130 TB/HIV co-infected patients who attended the TB clinic were taken and data was analyzed. by Statistical Package for Social Sciences version 21. Multivariable binary logistic regression analysis was carried out to identify predictors of treatment outcome. Statistical significance was considered at p-value <0.05. The treatment outcomes of TB patients included in this study were 13(10.0%) cured, 14 (10.64%) defaulted, 18 (12.47%) died and 29 (22.04%) completed the treatment. Initial World Health Organization (WHO) clinical stage III and stage IV were associated with unfavorable outcome. Both WHO stages (III, IV) at the time of HIV diagnosis were independent predictors of poor treatment outcome. However, smear positive TB was an independent predictor of a favorable treatment outcome. This study revealed that treatment outcome of TB patients was unsatisfactory, which signals a need for improved care. Advanced WHO clinical stages were predictors of poor outcome, while smear positive TB favors good outcome.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2018.15330.2816
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