Abstract
BackgroundIn sub-Saharan Africa, as high as 2/3 of tuberculosis patients are HIV/AIDS co-infected and tuberculosis is the most common cause of death among HIV/AIDS patients worldwide. Tuberculosis and HIV co-infections are associated with special diagnostic and therapeutic challenges and constitute an immense burden on healthcare systems of heavily infected countries like Ethiopia. The aim of the study was to determine the prevalence of pulmonary tuberculosis and their immunologic profiles among HIV positive patients.MethodsA cross sectional study was conducted among adult HIV-positive patients attending HIV/AIDS clinic of Gondar University Hospital. Clinical and laboratory investigations including chest x-ray and acid fast staining were used to identify tuberculosis cases. Blood samples were collected to determine CD4+ lymphocyte count. A structured questionnaire was used to collect socio-demographic characteristics of study subjects. The data was entered and analyzed using SPSS version 16 software.ResultsA total of 400 HIV positive study participants were enrolled. Thirty (7.5%, 95%CI: 5.2-10.6%) of the study participants were found to have pulmonary tuberculosis. In multivariate analysis, only CD4+ lymphocyte count (AOR = 2.9; 95% CI: 1.002-8.368) was found to be independently associated with tuberculosis-HIV co-infection. Individuals who had advanced WHO clinical stage were also statistically significant for co-infection. The mean CD4+ lymphocyte count of HIV mono-infected participants were 296 ± 192 Cells/mm3 and tuberculosis-HIV co-infected patients had mean CD4+ lymphocyte count of 199 ± 149 Cells/mm3 with p value of 0.007.ConclusionsWe found high prevalence of tuberculosis-HIV co-infection. Lower CD4+ lymphocyte count was found to be the only predicting factor for co-infection. Early detection of co-infection is very necessary to prolong their ART initiation time and by then strengthening their immune status.
Highlights
In sub-Saharan Africa, as high as 2/3 of tuberculosis patients are human immune deficiency virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) co-infected and tuberculosis is the most common cause of death among HIV/AIDS patients worldwide
Unlike other opportunistic infections which occur at Cluster of Differentiation (CD4)+ lymphocyte count below 200/mm3, active TB occurs throughout the course of HIV disease [13]
The aim of this study was to determine the prevalence of pulmonary tuberculosis (PTB) among pre-antiretroviral treatment (ART) HIV positive patients and their immunologic profiles which is important for health professionals and policy makers to make evidence based decisions
Summary
In sub-Saharan Africa, as high as 2/3 of tuberculosis patients are HIV/AIDS co-infected and tuberculosis is the most common cause of death among HIV/AIDS patients worldwide. The prevalence of TB-HIV Co-infection is higher worldwide and 90% of these coinfected cases live in developing nations [1,2,3]. Tuberculosis is the most common opportunistic disease and cause of the death for those infected with HIV [3]. An estimated 1.37 million HIV positive TB patients were diagnosed globally in 2007, and around 80% of them live in sub-Saharan Africa [11]. Unlike other opportunistic infections which occur at CD4+ lymphocyte count below 200/mm, active TB occurs throughout the course of HIV disease [13] Tuberculosis and HIV co-infections are associated with special diagnostic and therapeutic challenges and constitute an immense burden on healthcare systems of heavily infected countries like Ethiopia [12].
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