Effectiveness of anti-tuberculosis drugs in tuberculosis and HIV co-infected patients coming to tertiary health-care center in South Gujarat

Abstract

Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) are major public health problems in most of the developing countries, including India. For developing TB, HIV infection is one of the strongest risk factors. The presentation and outcome of TB are affected by HIV infection. Aims and Objectives: The objective is to study the type of TB, level of CD4 count, TB presentation in TB-HIV patients. Observation of anti-TB treatment, adverse drug reactions (ADR), and outcome of anti-TB treatment in patients with TB-HIV co-infection. Materials and Methods: The present study is an observational, longitudinal, prospective, and single-center study of adult patients having TB-HIV co-infection. To evaluate the clinical course, outcome, and safety of anti-TB drugs, the selected patients were followed up during the study. Results: In our study, 59 patients of TB-HIV co-infection on anti-TB treatment were observed. About 61% of the patients were msale. Most of the patients had pulmonary TB (61%) and extra-pulmonary TB (EPTB) was found in 38.9% of patients. Tuberculous pleural effusion and cervical tuberculous lymphadenitis were the most common among EPTB cases. 93.2% of cases were drug-sensitive TB and 6.8% cases were drug-resistant TB. Low CD4 count <200 cell/cu.mm were observed in 61% of patients. All patients were treated according to RNTCP and National AIDS Control Organization guidelines. Majority of cases (67.8%) had no ADR. The most common ADR observed were gastritis and GIT symptoms (15.3%). Successful treatment was observed in 41 patients (69.5%), and interim outcomes were observed in 2 patients (3.4%). Three patients (5.1%) were transfer out, 6 patients (10.2%) were lost to follow-up, 7 patients (11.9%) died. Among patients who had CD4 count <200 cell/cu.mm, successfully treated patients were 61.1%, and among patients who had CD4 count ≥200 cell/cu.mm, 82.6% of patients were successfully treated. Conclusion: Pulmonary TB is common than EPTB. In most of the patients, anti-TB drugs are effective, also well tolerated with ADRs in few patients. Most of ADRs are non-serious. The success rate of treatment is more among patients who had CD4 count ≥200 cell/cu.mm than among patients who had CD4 count <200 cell/cu.mm.