HIV-TB Co-infection Research Articles

Serum and Bronchoalveolar Lavage Fluid 25(OH)Vitamin D3 Levels in HIV-1 and Tuberculosis: A Cross-Sectional Study from a Tertiary Care Center in North India.

Vitamin D is an immunomodulator, and its deficiency is associated with Tuberculosis (TB) infection. Bronchoalveolar lavage fluid (BALF) is a rich milieu of macrophages that form the first line of defense against invading TB bacilli. As there is an increased prevalence of vitamin D deficiency in TB and human immunodeficiency virus-1 (HIV-1) subjects, we intend exploring the possibility of a localized deficiency of vitamin D metabolites in BALF of these patients. The primary objective was to assess the level of 25D3 in serum and BALF of subjects and look for a significant difference among patients and controls. The secondary objective was to find a correlation between serum and BALF 25D3 levels. We performed a cross-sectional study with subjects divided into four groups: Controls (group 1), HIV positive without active TB (group 2), active TB without HIV (group 3), and HIV-TB coinfection (group 4). BALF and serum 25D3 levels were compared between the groups. Among the 149 (an immunomodulator) successive subjects enrolled, there were 40 subjects in group 1 (HIV-TB-), 48 in group 2 (HIV+TB-), 37 in group 3 (HIV-TB+), and 24 in group 4 (HIV+TB+). Females constituted 31.6% of the study subjects. In groups 3 and 4, there were significantly lower serum 25D3 levels compared to group 1 (p-value group 3: 0.002; group 4: 0.012). In groups 2, 3, and 4, there were significantly lower BALF 25D3 levels compared to group 1 (p-value group 2: 0.000; group 3: 0.000; group 4: 0.001). There was a significant correlation between serum and BALF 25D3 levels (Spearman's rank correlation coefficient 0.318, p-value = 0.0001). Lower levels of serum and BALF 25D3 were observed in HIV, TB, and HIV-TB coinfected patients. Localized deficiency of vitamin D metabolites might be associated with increased vulnerability to TB infection.

Assessing the effects of treatment in HIV-TB co-infection model

We propose a population model for HIV-TB co-infection dynamics by considering treatments for HIV infection, active tuberculosis and co-infection. The HIV only and TB only models are analyzed separately, as well as full model. The basic reproduction numbers for TB ($\mathcal{R}_0^T$) and HIV ($\mathcal{R}_0^H$) and overall reproduction number for the system $\mathcal{R}_0= \max\{\mathcal{R}_0^T, \mathcal{R}_0^H\}$ are computed. The equilibria and their stability are studied. The main model undergoes supercritical transcritical bifurcation at $\mathcal{R}_0^T=1$ and $\mathcal{R}_0^H=1$ whereas the parameters $\beta^*=\beta e$ and $\lambda^*=\lambda \sigma$ act as bifurcation parameters, respectively. Numerical simulation claims the existence of interior equilibrium when both the reproduction numbers are greater than unity. We explore the effect of early and late HIV treatment on disease-induced deaths during the TB treatment course. Mathematical analysis of our model shows that successful disease eradication requires treatment of single disease, that is, treatment for HIV only and TB only infected individuals with addition to co-infection treatment and in absence of which disease eradication is extremely difficult even for $\mathcal{R}_0<1$. When both the diseases are epidemic, the treatment for TB only infected individuals is very effective in reducing the total infected population and disease-induced deaths in comparison to the treatment for HIV infected individuals while these are minimum when both the single disease treatments are given with co-infection treatment.

Trends in, and factors associated with, HIV infection amongst tuberculosis patients in the era of anti-retroviral therapy: a retrospective study in England, Wales and Northern Ireland

BackgroundHIV increases the progression of latent tuberculosis (TB) infection to active disease and contributed to increased TB in the UK until 2004. We describe temporal trends in HIV infection amongst patients with TB and identify factors associated with HIV infection.MethodsWe used national surveillance data of all TB cases reported in England, Wales and Northern Ireland from 2000 to 2014 and determined HIV status through record linkage to national HIV surveillance. We used logistic regression to identify associations between HIV and demographic, clinical and social factors.ResultsThere were 106,829 cases of TB in adults (≥ 15 years) reported from 2000 to 2014. The number and proportion of TB patients infected with HIV decreased from 543/6782 (8.0%) in 2004 to 205/6461 (3.2%) in 2014. The proportion of patients diagnosed with HIV > 91 days prior to their TB diagnosis increased from 33.5% in 2000 to 60.2% in 2013. HIV infection was highest in people of black African ethnicity from countries with high HIV prevalence (32.3%), patients who misused drugs (8.1%) and patients with miliary or meningeal TB (17.2%).ConclusionsThere has been an overall decrease in TB-HIV co-infection and a decline in the proportion of patients diagnosed simultaneously with both infections. However, high rates of HIV remain in some sub-populations of patients with TB, particularly black Africans born in countries with high HIV prevalence and people with a history of drug misuse. Whilst the current policy of testing all patients diagnosed with TB for HIV infection is important in ensuring appropriate management of TB patients, many of these TB cases would be preventable if HIV could be diagnosed before TB develops. Improving screening for both latent TB and HIV and ensuring early treatment of HIV in these populations could help prevent these TB cases. British HIV Association guidelines on latent TB testing for people with HIV from sub-Saharan Africa remain relevant, and latent TB screening for people with HIV with a history of drug misuse, homelessness or imprisonment should also be considered.

Prospective study of tubercular co-infection in HIV infected patients in VIMSAR, Burla, Sambalpur, Odisha, India

Background: Tuberculosis is the most common opportunistic infection in HIV positive patient. This is a major challenge faced by HIV positive patient. Methods: This study was carried out at Medicine Department and ART Centre, VIMSAR, Burla to know the epidemiology and clinical profile of HIV and TB co-infection. This is a prospective study in which all adult patients attending to our hospital for period of one year with HIV-TB co infection are enrolled. There were 269 patients. The clinical parameters are studied after all detailed history and clinical examination. The diagnosis of Tuberculosis was made by relevant investigation like Sputum AFB, Chest X-ray, CSF Study, CT Scan, Pleural Fluid Study, Ascitic fluid study etc.Results: The results indicate majority of the patients out of 211 patients 74 (82.52%), were male 34(16.35%)were female and TGTS were-3(1.42%). Age group mostly affected were 26-35 years (38.1%) and 36-45 years (38.1 %). Extra-pulmonary TB constituted 56.28% and Pulmonary TB-43.72%. 41.99% completed anti-TB treatment and mortality was 12.99%. Mean CD4 count at the time of diagnosis-218iu/l; and patients with low CD4 cell count at the time of diagnosis had high mortality.Conclusions: Extra-pulmonary TB is predominant among HIV TB co-infection and the working-class population affected more than the rest TB Meningitis and Disseminated TB are associated with a bad prognosis when compare to other forms of TB. A low CD4 count at the time of Tuberculosis diagnosis is associated with a higher mortality and early suspicion diagnosis of tuberculosis and early initiation of ATT in HIV patients reduces mortality and morbidity significantly.

A qualitative exploration of doctors and nurses experiences on the management of tuberculosis and HIV co-infection in a tuberculosis-HIV high burden community in northern KwaZulu-Natal, South Africa.

South Africa is faced with a huge challenge of addressing the high burden of tuberculosis-human immune virus (TBHIV) co-infection, and this challenge is more pronounced in the province of KwaZulu-Natal which has one of the highest burdens of TB-HIV co-infection in the world. The study explored the experiences of doctors and nurses with regard to the management of tuberculosis and HIV coinfection in a TB-HIV high burden community in northern KwaZulu-Natal, South Africa. The particular focus was to provide insight and to inform policy and programme development for effective management of TB-HIV co-infection in the TB-HIV high burden community of northern KwaZulu- Natal. An interpretivist exploratory qualitative approach was employed through individual semi-structured interviews of 16 participants comprising eight doctors and eight nurses, with a total interview time of 8.95 hours. Purposive sampling was used to select the doctors and nurses from the public and private sector of the TB-HIV high burden community of northern KwaZulu- Natal. Thematic analysis was used to analyse the data. Five key themes emerged from this study and these themes were discussed together with the sub-themes based on the various participant responses. The five key themes were practical experience about the management of TB-HIV co-infection; access to information and training on the management of TB-HIV co-infection; challenges and concerns about the management of TB-HIV co-infection; perception about local beliefs; and knowledge of policies and guidelines. Overall, this study highlights barriers that hamper the effective management of TB-HIV co-infection in northern KwaZulu-Natal. Recommendations of this study point towards an urgent need to scale up the management of TB-HIV co-infection through effective policies, improved capacity and infrastructure, stronger partnerships of all stakeholders, and further research.

Timing of HIV diagnosis in children with tuberculosis managed at a referral hospital in Cape Town, South Africa.

Tygerberg Hospital, Western Cape Province, Cape Town, South Africa. To investigate the prevalence of and factors associated with simultaneous tuberculosis (TB) and human immunodeficiency virus (HIV) diagnoses in children. Retrospective cohort study in TB-HIV co-infected children aged <13 years admitted to Tygerberg Hospital in 2012. Data were collected from medical records, laboratory results and electronic TB treatment registers. A simultaneous TB-HIV diagnosis was defined as an HIV diagnosis made within 7 days before or after a diagnosis of TB. Of 88 children with TB-HIV co-infection, 37 (42%) had a simultaneous TB-HIV diagnosis; 51 children had been known to have HIV before their TB diagnosis. Interruption of antiretroviral therapy (ART) was reported in 9/32 (28%) children with known HIV infection at TB diagnosis, while missed opportunities for ART initiation were identified in 8/19 (42%) ART-naïve children. Simultaneous TB-HIV diagnosis was more likely if maternal HIV infection was unknown at the time of the child's birth (OR 2.7, 95%CI 1.0-7.2), and was associated with unfavourable TB treatment outcomes (OR 5.9, 95%CI 1.4-25.2). TB diagnosis provides an important opportunity to test children for HIV. Missed opportunities for HIV prevention, earlier diagnosis and ART initiation were identified.

Determination of dehydroepiandrosterone and its biologically active oxygenated metabolites in human plasma evinces a hormonal imbalance during HIV-TB coinfection

An estimated one third of the world’s population is affected by latent tuberculosis (TB), which once active represents a leading cause of death among infectious diseases. Human immunodeficiency virus (HIV) infection is a main predisposing factor to TB reactivation. Individuals HIV-TB co-infected develop a chronic state of inflammation associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation. This results in a hormonal imbalance, disturbing the physiological levels of cortisol and dehydroepiandrosterone (DHEA). DHEA and its oxygenated metabolites androstenediol (AED), androstenetriol (AET) and 7-oxo-DHEA are immunomodulatory compounds that may regulate physiopathology in HIV-TB co-infection. In order to study possible changes in plasma levels of these hormones, we developed an approach based on high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). To our knowledge, this represents the first report of their simultaneous measurement in HIV-TB individuals and the comparison with healthy donors, obtaining statistically higher plasma levels of DHEA, AET and 7-oxo-DHEA in patients. Moreover, we found that concentrations of 7-oxo-DHEA positively correlated with absolute CD4+ T cell counts, nadir CD4+ T cell values and with individuals who presented TB restricted to the lungs. This research contributes to understanding the role of these hormones in HIV-TB and emphasizes the importance of deepening their study in this context.

4.10-P12Perspectives of health care providers in Portugal on the provision of care to migrant patients with TB or HIV-TB co-infection

4.10-P12Perspectives of health care providers in Portugal on the provision of care to migrant patients with TB or HIV-TB co-infection

Hypovitaminosis D increases TB co-infection risk on HIV patients

Tuberculosis is causes of mortality and morbidity in patients with HIV. Hypovitaminosis D, a defective cell-mediated immune response to Mycobacterium tuberculosis infection has been extensively described in HIV patients, but studies assessing the role of vitamin D in TB-HIV co-infection are lacking. We, therefore, conducted a 1:1 pair- matched case-control study to verify hypovitaminosis D possible risk factor of TB- HIV co- infection. Consecutive HIV patients starting ARV and sex, age and CD4 cell count matched were by recruiting. Tuberculosis has confirmed by thepresence of acid-fast bacilli in sputum or mycobacterium detected in specimens culture/Gene Xpert/PCR. Vitamin D levels were by measuring direct chemiluminescent immunoassay on a LIAISON®25OH analyzer. The study comprised 25 cases and 25 controls, median (interquartile range) 25(OH)D3 serum concentration were 19.80 (12.15-27.45) ng/mL in cases and 33.30 (27.2-39.4) ng/mL in controls (P<0.001). After adjustment for potential confounders included anemia, smoking,and low BMI, with multivariate logistic regression analysis, hypovitaminosis Dindependently associated with the development of active tuberculosis in HIV patients.(OR 26.154 (90% CI: 4.371-156.541); p <0.001). The finding indicates that hypovitaminosis D was a risk factor of TB-HIV co-infection.

HIV-TB Co-Infection among Clients Attending an Integrated Counselling &amp; Testing Centre at Agra: Comparison with Studies in other Regions of India

HIV-TB Co-Infection among Clients Attending an Integrated Counselling &amp; Testing Centre at Agra: Comparison with Studies in other Regions of India

Evaluation of a synthetic peptide for the detection of anti-Mycobacterium tuberculosis curli pili IgG antibodies in patients with pulmonary tuberculosis

Tuberculosis (TB) remains a serious threat in underdeveloped areas. Mycobacterium tuberculosis curli pili (MTP), a virulence factor, is a potential biomarker for a reliable point of care (POC) test and was evaluated for its ability to react with Immunoglobulin G (IgG) in TB patients. An MTP synthetic peptide in a slot blot assay was used to screen serum/plasma samples (n = 65) in 3 separate cohorts, including 40 TB positive (16 HIV co-infected), 20 TB negative/HIV negative patients and 5 healthy volunteers. Forty samples were true positives (HIV positive, n = 16), 23 true negatives (HIV negative) and 2 false positives (HIV negative). The McNemar test demonstrated a 3.08% accuracy estimate (CI: −2.1% - 3.08%). This confirms that MTP is expressed during infection, including HIV-TB co-infection, is likely to be suitable for the design of a POC test and supports the validation of MTP for TB detection in larger patient populations.

New hydrazides derivatives of isoniazid against Mycobacterium tuberculosis: Higher potency and lower hepatocytotoxicity

Tuberculosis (TB) is one of the leading causes of death worldwide. The emergence of multi-drug resistant strains of Mycobacterium tuberculosis (Mtb) and TB-HIV co-infection are major public health challenges. The anti-TB drugs of first choice were developed more than 4 decades ago and present several adverse effects, making the treatment of TB even more complicated and the development of new chemotherapeutics for this disease imperative. In this work, we synthesized two series of new acylhydrazides and evaluated their activity against different strains of Mtb. Derivatives of isoniazid (INH) showed important anti-Mtb activity, some being more potent than all anti-TB drugs of first choice. Moreover, three compounds proved to be more potent than INH against resistant Mtb. The Ames test showed favorable results for two of these substances compared to INH, one of which presented expressly lower toxicity to HepG2 cells than that of INH. This result shows that this compound has the potential to overcome one of the main adverse effects of this drug.

Bacteriological Prevalence of Tuberculosis Among Children Seen in Health Facilities in Nasarawa State, Nigeria

Background: Tuberculosis, a disease of significant public health importance remains a leading cause of childhood morbidity and mortality globally. Under-reporting of new cases is a major setback in the correct estimate of the global burden of pediatric TB. Data on pediatric TB from TB-endemic countries being limited. It is recommended that continuous research be conducted to ascertain and better understand the magnitude of the problem and to provide reliable, timely and cost-efficient information for action. Objective: This study was undertaken to determine the bacteriological prevalence of tuberculosis and TB-HIV co-infection among children seen in health facilities in Nasarawa state, North-Central Nigeria. Subjects and Method: The study subjects consisted of one hundred and fifty (150) children aged 18 months to 15 years who were selected using multi-stage sampling technique. Data, was obtained from their care-givers using interviewer administered questionnaires. The study subjects had their sputum or gastric aspirates samples collected for acid-fast bacilli microscopy and culture. Blood samples were taken for HIV screening. Data was analyzed using SPSS statistical software version 17.0. Results: The ages of the subjects averaged 9.12±4.66 years and majority of them were females with male to female ratio of 0.92:1. The prevalence of tuberculosis found among them by microscopy and culture are 16.7% and 30.0% respectively while the prevalence of definite TB case was 32% which is 5.5 times higher than the reported national average. The prevalence of 10.0% for TB-HIV co-infection was also found among the study subjects. Conclusion: There is a high burden of pediatric TB in Nasarawa State (higher than average national prevalence). This study can be extended to six Geopolitical regions of Nigeria, to find out the true situation nationwide.

Adalimumab for Corticosteroid and Infliximab-Resistant Immune Reconstitution Inflammatory Syndrome in the Setting of TB/HIV Coinfection.

Corticosteroids are the mainstay of therapy for immune reconstitution inflammatory syndrome (IRIS). However, little is known about how to treat IRIS unresponsive to steroids. We report a patient with HIV-TB coinfection who was unresponsive to first prednisolone and then infliximab but whose IRIS resolved with adalimumab.

Assessment of recombinant plasmid expressing fusion antigen Ag85B-Rv3425 in management of acute tuberculosis infection in mice.

The emergence of drug-resistant tuberculosis (TB) and HIV-TB co-infection fuels an urgent need to develop novel therapeutic approaches, including therapeutic vaccines. Therapeutic vaccines have been proven to be a good strategy by inducing antigen specific immune responses against TB infection. In the present study, a recombinant plasmid based on lentiviral vector expressing fusion antigen Ag85B-Rv3425 (A3), and was constructed the immunogenicity and treatment effects in TB mice were assessed. The results showed that A3 delivered by the plasmid could be expressed appropriately in vivo and induced higher production of tumor necrosis factor-α and interleukin-2 compared with A3 recombinant protein in mice. Moreover, the recombinant plasmid expressing A3 confered resistance to acute TB infection in mice, characterized by a reduction in the bacterial load in the lungs and spleen, as well as attenuated TB lesions in lung tissues. These results implicated that the recombinant plasmid based on lentiviral vector expressing A3 is a potent and promising therapeutic agent to treat acute TB infection.

Prévalence de la co-infection VIH-tuberculose et impact du VIH sur les tuberculeux dans la zone de santé de Lubumbashi de 2014 à 2015

Tuberculosis and HIV/AIDS are a dangerous couple in sub-Saharan Africa. The aim of this paper is to evaluate the prevalence of the co-infection tuberculosis/HIV/AIDS and its impact on issues of tuberculosis patients treated in Lubumbashi Heath Zone (LHZ). A retrospective and transversal study was conducted through the analysis of tuberculosis patients' data admitted in the tuberculosis Health Centers for Diagnosis and treatment (HCDT) in the LHZ from January 2014to December 2015. TB-HIV co-infection cases will be identified and the outcome will be analyzed. Data of 1368patients were noted from three HCDT of the TB of the Lubumbashi ZS and among them 334cases of co-infections were recorded. The most incriminated age range is 40-50years. The mean of age of our patients is 32.84±15.32years and the man/women sex ratio is 1.70. The most predominant clinical tuberculosis form is the extra pulmonary [EPT (52.70%)]. Among co-infected patients, the predominant form is pulmonary (TPM-). Out of the 51cases of deaths recorded, 23 (45.10%) also had HIV while 28 (54.90%) were HIV-negative. There was an increase of 11.6% in TB-HIV/AIDS co-infection from 2014to 2015. TB-HIV/AIDS co-infection is a reality in the LHZ, especially in patients with negative bacterial TB (TPM-) and we have to pay a particular attention on the impact of HIV on the death of tuberculosis patients.

The impact of rural residence and HIV infection on poor tuberculosis treatment outcomes in a large urban hospital: a retrospective cohort analysis

BackgroundSuccessful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria.MethodsWe retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes.ResultsAmong 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27–3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16–1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15–5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49–2.64).ConclusionRural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings.

HIV-TB Coinfection among 57 Million Pregnant Women, Obstetric Complications, Alcohol Use, Drug Abuse, and Depression.

Objective HIV and tuberculosis represent diseases of major public health importance worldwide. Very little is known about HIV-TB coinfection among pregnant women, especially from industrialized settings. In this study, we examined the association between TB, HIV, and HIV-TB coinfection among pregnant mothers and obstetric complications, alcohol use, drug abuse, and depression. Method We examined inpatient hospital discharges in the United States from January 1, 2002, through December 31, 2014. We employed multivariable survey logistic regression to generate adjusted estimates for the association between infection status and study outcomes. Results We analyzed approximately 57 million records of pregnant women and their delivery information. HIV-TB coinfection was associated with the highest risks for several obstetric complications, alcohol use, and drug abuse. The risk for alcohol abuse was more than twice as high among HIV-monoinfected as compared to TB-monoinfected mothers. That risk gap more than doubled with HIV-TB coinfection. Both HIV-monoinfected and HIV-TB coinfected mothers experienced similarly increased risks for depression. Conclusions Mothers with HIV-TB coinfection experienced relatively heightened risks for obstetric complications, alcohol use, and drug abuse. The findings of this study underscore the importance of augmenting and enhancing social and structural support systems for HIV-TB coinfected pregnant women.

Associations of Contact History, Smoking Status, Nutrition Status, Anti Retrovirus Treatment, and TB HIV Co-infection Among People with HIV/AIDS

Background: Tuberculosis (TB) and HIV co-infection causes a heavy burden on health care systems and poses particular diagnostic and therapeutic challenges. Studies into predictors of TB-HIV co-infection is lacking in Indonesia. This study aimed to examine the associations of contact history, smoking status, nutrition status, ARV treatment, and TB HIV co-infection among people with HIV/AIDS (PLWH). Subjects and Method: This was a unmatched case-control study conducted in Balige, North Sumatera. A sample of 82 people living with HIV/AIDS was selected for this study, comprising 41 cases with and 41 controls without TB-HIV co-infection. The dependent variable was TB-HIV co-infection. The independent variables were contact history, smoking status, nutrition status, and anti retroviral (ARV) treatment. The data on HIV/AIDS co-infection were taken from the medical record at HKBP Committee HIV/AIDS service. Other variables were measured by questionnaire. Data were analyzed by a multiple logistic regression. Results: 82.9% of PLWH had no contact history with TB patients, 56.1% had poor nutrition status, 78% were smokers, and 58.5% had irregular ARV treatment. The risk of TB HIV co-infection increased with poor nutrition status (OR=3.48; p=0.014), smoking (OR=3.39; p=0.021), and irregular ARV treatment (OR=10.16; p<0.001). Test results multiple ARV treatment is the most dominant variable affecting the incidence of TB-HIV co-infection (OR= 8.04; 95% CI= 2.47 to 26.18; p<0.001). Conclusion: The risk of TB HIV co-infection increases with poor nutrition status, smoking status, and irregular ARV treatment. Keywords : TB, HIV co-infection, nutrition status, smoking, ARV treatment, people living with HIV/AIDS Correspondence: Adymulianto Manurung. Masters Program in Public Health, Universitas Sumatera Utara, Jl. Universitas n0.21, Universitas Sumatera Utara, Medan 20115. Email: adymulianto_manurung@yahoo.com. Mobile: 085296652111. Journal of Epidemiology and Public Health (2019), 4(1): 60-64 https://doi.org/10.26911/jepublichealth.2019.04.01.08

HIV co-infection in patients followed up for tuberculosis in the Division of Infectious Diseases at the Ibn Rochd University Hospital in Casablanca

L'objectif du travail est de déterminer la prévalence de l'infection par le VIH chez les tuberculeux hospitalisés au service des maladies infectieuses du CHU Ibn Rochd-Casablanca et de chercher les facteurs associés à la co-infection Tuberculose-VIH. Nous avons mené une étude transversale rétrospective menée en Novembre 2016, en se basant sur l'exploitation de la base de données du service des maladies infectieuses, des laboratoires de microbiologie et d'immunologie du CHU Ibn Rochd. Etaient inclus les patients ayant une tuberculose confirmée par culture positive sur milieu de Lowenstein Jensen et une infection à VIH confirmée par Western Blot entre Janvier 2013 et Décembre 2015. Au cours de la période de l'étude, 117 cas de tuberculose ont été confirmés par culture. Parmi ces patients, 46 (39,3%) avaient une infection à VIH confirmée. Trente-quatre patients co-infectés (73,9%) avaient une tuberculose extra pulmonaire (cette forme était associée à la co-infection (p=0,04)). Tous les patients ont été mis sous traitement antituberculeux et antirétroviral selon l'indication. L'évolution était favorable chez 32 patients (69,6%) et 10 décès ont été enregistrés (21,7%). La mortalité était plus élevée chez les co-infectés que chez les tuberculeux non atteints par le VIH (8,4%), (p=0,04). Cette étude a objectivé une prévalence relativement élevée de l'infection par le VIH parmi les tuberculeux. La co-infection Tuberculose-VIH est associée aux formes graves de la tuberculose et à une augmentation de la mortalité chez les tuberculeux, d'où l'intérêt du renforcement des activités conjointes de lutte contre cette co-infection.