Prevalence of HIV-TB co-infection, clinical profile and CD4 count of HIV patients attending ART centre of Ahmednagar, Maharashtra

Abstract

Background: HIV-TB co-infection has become a major public health problem worldwide. TB has become the major cause of death in HIV positive patients. Clinical course and pattern of opportunistic infections in HIV patients is changing worldwide. Aims & Objective: To study prevalence of HIV-TB co-infection and socio-demographic & clinical profile of HIV-AIDS patients attending anti-retroviral therapy (ART) centre in a rural area, Ahmednagar district of Maharashtra. Materials and Methods: A cross-sectional study was conducted from November 2013 to April 2014 at an antiretroviral therapy centre of a rural tertiary care hospital, situated in Maharashtra state of India. Interview of 385 HIV positive individuals was taken by using pre-designed questionnaire which included socio-demographic and clinical profile, opportunistic infections and CD4 counts of the patients. Results: More than two third (71.43%) of the study population were in sexually active age group i.e. 30-45 years. Females were 46.8% and males were 53.2%. Most of them were from upper lower socioeconomic (46.23%) and lower (secondary level) educational status. Fatigue, weight loss, fever, cough, diarrhoea were common clinical features. Most common opportunistic infection was herpes zoster (47.27%). Heterosexual route was main route of transmission. Most of the female respondents were widows (66.67%) and 48.29% were discordant couple. 46.75% patients were in the third stage of disease. Mean CD4 count at the start of treatment was 152.9 ± 92.45. Prevalence of HIV-TB co-infection was 21.56%. Conclusion: Opportunistic infections were associated with CD4 count and CD4 count was associated with A.R.T. therapy. Primary as well as secondary preventive measures could be implemented effectively.

Prevalence and risk factors for opportunistic infections in HIV patients who developed adverse drug reactions (ADRs) to antiretroviral therapy (ART) in a tertiary-care teaching hospital

“…The study by Ghate et al [22] showed TB was the most common OI, followed by oral candidiasis, herpes zoster, and cryptococcal meningitis. In contrast, Gautam et al [23] showed that herpes zoster was the most common OI, followed by TB, skin infection, and chronic diarrhea. Saha et al [24] showed that the common co-infections/OIs were oral candidiasis followed by chronic diarrhea, HSV-2, TB, CMV, HBV, and HCV, while Elizabeth et al [25] showed that the most common OIs were oropharyngeal candidiasis followed by TB.…”

Oral Manifestations in HIV-TB Co- infected Patients and Their Correlation with CD4 Count in Telangana State, India

“…Similarly, current guidelines suggest that there is an increased risk of oropharyngeal candidiasis with CD4 count below 200/mm 3 [24] but in this study, majority of cases were seen with CD4 count between 200 and 500/ mm 3 . Even though there was a significant association of the type of TB with CD4 count, oral lesions were observed irrespective of CD4 count, indicating that TB may act as a cofactor to accelerate or modify the clinical course of HIV infection as proposed by Whalen et al [34][35][36] OHL was significantly observed in the younger age-groups, which heralds severity of the HIV infection. [37] The gender differences for the oral presentation among patients coinfected with HIV-TB were observed with males being the significantly affected gender with a predilection for manifestations such as erythematous candidiasis and lobulated tongue, and females with palatal papules.…”