HIV status among presumptive tuberculosis cases attending tertiary care centre in South India.

Manju Rajaram,Jayalakshmi Ramakrishnan,Dharm Prakash Dwivedi,Adimulam Ganga Ravindra,Madhusmita Mohanty Mohapatra,Palanivel Chinnakali

doi:10.5603/arm.2018.0033

Abstract

In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group on TB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases. Our study was a cross-sectional study, conducted between June 2015 and December 2016 in a tertiary care institute (JIPMER), in South India, to estimate the prevalence of HIV among presumptive TB cases. Among the 964 presumptive TB cases who attended pulmonary medicine OPD, 189 patients were sputum acid-fast bacilli (AFB) positive. Among the 189 sputum positive cases, 9 were HIV positive. Of the 964 presumptive TB cases, 879 gave consent for HIV testing and 33 (3.7%) turned out to be HIV positive. If only sputum positive cases had been screened for HIV, we would have missed 24 new HIV positive cases. The number needed to screen was 27 among presumptive TB cases and 18 among TB patients. The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptive TB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry. This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so that anti-retroviral therapy (ART) can be initiated early.

Highlights

In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group on TB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases
For early diagnosis of HIV infection among patients presenting to the health care settings with symptoms of tuberculosis, the World Health Organization (WHO) had issued an updated policy statement in March 2012 that Provider- Initiated HIV Testing and Counseling (PITC) should be offered to TB patients and to all presumptive TB cases [2]
Routine screening of presumptive TB cases for HIV is being implemented in phase wise manner throughout the country

Summary

Introduction

In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group on TB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases. Conclusions: The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptive TB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so that anti-retroviral therapy (ART) can be initiated early. For early diagnosis of HIV infection among patients presenting to the health care settings with symptoms of tuberculosis, the World Health Organization (WHO) had issued an updated policy statement in March 2012 that Provider- Initiated HIV Testing and Counseling (PITC) should be offered to TB patients and to all presumptive TB cases [2]. Routine screening of presumptive TB cases for HIV is being implemented in phase wise manner throughout the country

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Conclusion