Clinicodemographic profile and outcome of tuberculosis treatment in TB-HIV co-infected patients receiving daily ATT under a single window TB/HIV services delivery initiative

Abstract

The risk of death in HIV-TB coinfected individuals is far greater than in HIV-only patients. It is critical to provide timely and appropriate therapy in HIV-TB coinfected patients in order to reduce morbidity and mortality. The purpose of this study was to evaluate the clinical presentation and outcome of TB treatment in HIV-TB co-infected patients receiving daily anti-tubercular therapy (ATT) and concurrent antiretroviral therapy (ART) at a tertiary respiratory care centre in New Delhi, India. The research was cross-sectional, observational, and hospital-based A. From September 2018 to August 2019, a total of 53 patients with HIV-TB coinfection were enrolled at the Institute's ART centre. Patients were evaluated with a structured proforma. Data were evaluated using SPSS version 23.0 and p-value of less than 0.05 was considered statistically significant. Among the patients enrolled, the mean age was 35.98 years. Among the patients enrolled, 56.6% patients had EPTB, 32% had PTB and 11.3% had both PTB and EPTB. The majority of the enrolled patients (n=46, 86.7%) had favourable TB treatment outcomes, while 13.3% (n=7) had unfavourable outcome [including death (n=5) and loss to follow up (n=2)]. During the study and follow-up period, no patients transferred out or relapsed. In univariate analysis, low SES, bedridden functional status, low BMI, anaemia, hypoalbuminemia, and a low CD-4 cell count (<100 cells/mm3 were significantly associated with an unfavourable outcome. Bedridden functional status (p=0.002), anaemia (p=0.040), and low BMI (p<0.001) were independently associated with a poor outcome. Adequate disease knowledge and health education can be very beneficial in reducing morbidity and mortality. Early ART in combination with ATT can reduce mortality in TB-HIV co-infected patients.

Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies

“…Across 5 studies reporting adjusted analyses among people with HIV, clinical factors associated with unfavorable treatment outcomes included pulmonary (versus extrapulmonary) TB in 2 studies [ 145 , 146 ], previous TB treatment history in 3 studies [ 145 – 147 ], and TB medication adverse effects in 1 study [ 148 ] (Fig N in the S6 Appendix ). HIV-related factors associated with unfavorable treatment outcomes included low CD4 cell count in 2 studies [ 147 , 149 ], not being on HIV therapy in 1 study [ 145 ], and not taking cotrimoxazole prophylaxis in 2 studies [ 145 , 148 ]. Status of taking HIV antiretroviral therapy [ 147 ] and of taking cotrimoxazole therapy [ 146 ] had nonsignificant associations in 1 study each.…”