Impact of TB-HIV collaborative activities on case fatality among HIV-infected Tuberculosis patients in Gujarat, INDIA

Abstract

Background: Tuberculosis (TB) control efforts have been challenged by deadly interaction of TB and HIV (Human Immunodeficiency Virus) epidemics. To address this challenge in India, all TB patients are routinely offered HIV testing and HIV positive TB patients are provided CPT (Cotrimoxazole Prophylaxis Therapy) and ART (Anti-Retroviral Treatment) as part of TB/HIV collaborative activities. Objective: To study the impact of TB/HIV collaborative activities on case-fatality among HIV infected patients with tuberculosis. Methods: All TB registers maintained under National TB programme (RNTCP) in Gujarat were reviewed and data on HIV testing, ART, CPT and TB treatment outcomes were retrieved for all the TB patients registered in 2010. Results: Among 77,839 registered TB patients, 59,638 (75%) were ascertained for HIV status and 2,893 (4%) were HIV infected. Among those HIV infected TB patients, 95% received CPT and 68% received ART during TB treatment. Case fatality among patients who received both CPT and ART was 10% compared to 37% among those didn’t receive both. Conclusion: TB-HIV collaborative activities reduced mortality among HIV infected TB patients under program condition in Gujarat. The programme needs to sustain efforts of collaborative interventions to improve care for such co-infected patients. Moreover, future TB-HIV collaborative efforts should focus on early diagnosis of HIV and TB and prompt initiation of ART. Keywords: TB-HIV collaboration, Case-fatality, RNTCP, ART, CPT, Gujarat