Tuberculosis Treatment Outcomes of Patients Co-Infected With Tuberculosis And HIV At Jaramogi Oginga Odinga Teaching And Referral Hospital (JOOTRH), Kenya.

Abstract

Background:Human Immunodeficiency Virus (HIV) infection and Tuberculosis (TB) increase the rate of disease progression of each other, thereby reducing the survival time of the patients. TB disease is considered a preventable, detectable and curable disease that requires wider public- private partnerships. Causes of mortality include late TB and/or HIV diagnosis, late HAART initiation, overlapping drug toxicities or comorbidities, drug-drug interactions between rifamycin and antiretroviral drugs, and immune reconstitution syndrome of TB after ART initiation etc. The Kenya National TB cohort analysis showed poorer treatment outcomes to be higher among patients with unknown or undocumented HIV status followed by HIV positive TB patients. Nyanza province contributes TB(20%) and HIV (30%) burden of the national burden, with coinfection rate of 70% of TB patients against 53% national rate. Early diagnosis, treatment initiation and monitoring leads to improved survival. Methods: This was a retrospective study aimed at evaluating socio-demographic characteristics of 350 TB/HIV co-infected patients (adults and children) enrolled in JOOTRH and documented treatment outcomes, risk factors associated with mortality and lost to follow up between January 2012 and July 3013 who were followed up 8 months after completion of treatment. Conclusion:Early ART initiation in the intensive phase of TB treatment, use of Cotrimoxazole, being WHO stage I & II and CD4> 350cells/mm 3 were associated with reduced deaths or loss to follow up while being male gender, initiating or delaying treatment after 2 months of TB treatment, WHO stage III and IV and CD4 < 350cells/mm 3 were significantly associated with high mortality.