Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

Zeru, Melkamu A.

doi:10.4314/ahs.v21i3.7

Cited by 22 publications

(23 citation statements)

References 16 publications

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“…This report was in agreement with study conducted in the Ethiopia that reported history of TB contact [20] and duration of cough greater than 3 weeks were risk factors of TB [43].…”

Section: Discussionsupporting

confidence: 92%

GeneXpert has perfect test agreement with WHO recommended TB lipoarabinomannan antigen test for the diagnosis of TB among under five children from urine sample in Tuberculosis endemic setting of Ethiopia

Derese,

Teklu,

Kumalo

et al. 2023

Preprint

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Background Tuberculosis (TB) is one of the leading public health problems in children mainly due to difficulties in the diagnosis of disease in children. This study aimed to detect the diagnostic agreement between GeneXpert MTB/RIF and WHO recommended lipoarabinomannan (LAM) antigen test for the detection of TB in children using urine samples Methods Institutional based cross-sectional study was conducted on 337 children in Wolaita Sodo University comprehensive hospital. LAM antigen and GeneXpert methods were used to detect TB from urine sample. The agreement between two tests was assessed using Kappa statistics with the standard error (SE), concordance and disagreements statistics. Logistic regression was used to determine factors associated with TB and P-values less than 0.05 were considered as having a statistically significant association. Results M. tuberculosis was detected in 26 using TB LAM giving an overall prevalence of 7.7% and 29 (8.6%) using GeneXpert. The two tests had almost perfect agreement (Concordance of 99.1% and kappa value of 0.94 with standard error of 0.034) for the detection of TB in urine sample. Co-infections with other diseases [AOR = 4.00: 95% CI, 1.428, 11.203], cough for the previous two weeks [AOR = 3.700: 95% CI, 1.039, 13.183], night sweat [AOR = 4.255: 95% CI, 1.453, 12.463] and loss of appetite [AOR = 3.994: 95% CI, 1.444, 11.045] had significant associations with pulmonary TB among children in the study area. Conclusion Tuberculosis was still the public health concern among children of under five years old in the study area. The GeneXpert had almost perfect test agreement with WHO recommended TB LAM antigen test for the diagnosis TB among under five children, however, it needs further confirmation study with large sample size to use as diagnostic test.

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“…This report was in agreement with study conducted in the Ethiopia that reported history of TB contact [20] and duration of cough greater than 3 weeks were risk factors of TB [43].…”

Section: Discussionsupporting

confidence: 92%

GeneXpert has perfect test agreement with WHO recommended TB lipoarabinomannan antigen test for the diagnosis of TB among under five children from urine sample in Tuberculosis endemic setting of Ethiopia

Derese,

Teklu,

Kumalo

et al. 2023

Preprint

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“…The nding of 29% burden of TB/HIV co-infection in the two counties is largely comparable with previously pooled estimates across countries in Sub-Saharan Africa [31]. The prevalence was 31% in Tanzania [32], 27.7%, in Amhara region, 37.4% in Addis Ababa and 36.9% in Southern Ethiopia respectively [33], while in Uganda it was 49.2% [34]. The variation in these estimates across the studies could possibly be explained by the differences in study time, sample size, study settings, methods of diagnosis and the ability to systematically screen HIV on all TB patients.…”

Section: Discussionsupporting

confidence: 85%

Burden of HIV and treatment outcomes among TB patients in rural Kenya: a 9-year longitudinal study.

Ngari

Rashid

Sanga

et al. 2023

Preprint

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Background Although tuberculosis (TB) patients coinfected with HIV are at risk of poor treatment outcomes, there is paucity of data on changing trends of TB/HIV co-infection and their treatment outcomes. This study aims to estimate the burden of TB/HIV co-infection over time, describe the treatment available to TB/HIV patients and estimate the effect of TB/HIV co-infection on TB treatment outcomes. Methods This was a retrospective data analyses from TB surveillance in two counties in Kenya (Nyeri and Kilifi): 2012‒2020. All TB patients aged ≥ 18years were included. The main exposure was HIV status categorised as infected, negative or unknown status. World Health Organization TB treatment outcomes were explored; cured, treatment complete, failed treatment, defaulted/lost-to-follow-up, died and transferred out. Time at risk was from date of starting TB treatment to six months later/date of the event and Cox proportion with shared frailties models were used to estimate effects of TB/HIV co-infection on TB treatment outcomes. Results The study includes 27285 patients, median (IQR) 37 (29‒49) years old and 64% male. 23986 (88%) were new TB cases and 91% were started on 2RHZE/4RH anti-TB regimen. Overall, 7879 (29%, 95% 28‒30%) were HIV infected. The proportion of HIV infected patient was 32% in 2012 and declined to 24% in 2020 (trend P-value = 0.01). Uptake of ARTs (95%) and cotrimoxazole prophylaxis (99%) was high. Overall, 84% patients completed six months TB treatment, 2084 (7.6%) died, 4.3% LTFU, 0.9% treatment failure and 2.8% transferred out. HIV status was associated with lower odds of completing TB treatment: infected Vs negative (aOR 0.56 (95%CI 0.52‒0.61) and unknown vs negative (aOR 0.57 (95%CI 0.44‒0.73). Both HIV infected and unknown status were associated with higher hazard of death: (aHR 2.40 (95%CI 2.18‒2.63) and 1.93 (95%CI 1.44‒2.56)) respectively and defaulting treatment/LTFU: aHR 1.16 (95%CI 1.01‒1.32) and 1.55 (95%CI 1.02‒2.35)) respectively. HIV status had no effect on hazard of transferring out and treatment failure. Conclusion The burden of TB/HIV coinfection was within previous pooled estimate. Our findings support the need for systematic HIV testing as those with unknown status had similar TB treatment outcomes as the HIV infected.

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“…Viral load at 6 months in both the groups did not differ We observed that the TB infection rate was 4.8% among group A patients, whereas in group B the rate of TB infection was 6.6%. The prevalence rate of TB and HIV coinfection was reported in previous studies as 37.4% by Zeru 27 which was in concordance with 36.9% reported by Negussie et al 28 Kibret et al 29 reported a prevalence rate of 33% while 35.6% was reported by Mbithi et al 30 However, Mitku et al 31 have reported a 27.7% prevalence rate. These differences in the TB and HIV co-infection rate may be because of differences in the study design, study population, study protocol or immune status etc.…”

Section: Discussionsupporting

confidence: 81%

Effect of the timing of antiretroviral treatment initiation on CD4 count in children and youths living with HIV in North India

Singh,

Sharma,

Shrivastava

et al. 2024

Int J STD AIDS

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Background Immediate start of antiretroviral treatment (ART) among non-hospitalized outpatient children living with HIV may improve or worsen clinical outcomes due to immune reconstitution. Objective Role of immediate versus post-stabilization start of antiretroviral treatment in children and youths living with HIV on CD4 count and viral load suppression. Methods This was a single blinded, randomized controlled trial conducted on outpatients attending a tertiary care hospital associated HIV clinic in North India. We enrolled ART-naive children and youths living with HIV aged 18 months to 21 years in a 1:1 ratio. Block randomization was done using computerized software. Children and youths living with HIV were either started with ART on diagnosis immediately within 24 h (Group A) or post stabilization at 2 weeks (Group B) as per National AIDS Control Organization (NACO) India guidelines. Both groups were comparable for baseline characteristics. Results There was no significant difference seen in CD4 counts between two groups at 6 months follow up. CD4 count increased significantly in immediate group but not in post-stabilization group at 6 months. No significant changes/differences was seen in WHO clinical staging or anthropometry; one patient developed tuberculosis in both groups. Viral load at 6 months in both the groups did not differ significantly. Conclusion Immediate ART in children and youths living with HIV results in significant increase in CD4 count at 6 months follow up exemplifying immunological response to ART.

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Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

Cited by 22 publications

References 16 publications

GeneXpert has perfect test agreement with WHO recommended TB lipoarabinomannan antigen test for the diagnosis of TB among under five children from urine sample in Tuberculosis endemic setting of Ethiopia

GeneXpert has perfect test agreement with WHO recommended TB lipoarabinomannan antigen test for the diagnosis of TB among under five children from urine sample in Tuberculosis endemic setting of Ethiopia

Burden of HIV and treatment outcomes among TB patients in rural Kenya: a 9-year longitudinal study.

Effect of the timing of antiretroviral treatment initiation on CD4 count in children and youths living with HIV in North India

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