alexa Factors Associated With Pulmonary Tuberculosis-HIV Co-Infection in Treatment-Naive Adults in Jos, North Central Nigeria | OMICS International | Abstract
ISSN 2155-6113

Journal of AIDS & Clinical Research
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Research Article

Factors Associated With Pulmonary Tuberculosis-HIV Co-Infection in Treatment-Naive Adults in Jos, North Central Nigeria

Agbaji O1, 3#, Ebonyi AO2,3#, Meloni ST4, Anejo-Okopi JA3, Akanbi MO1,3, Oguche S2,3, Agaba PA3,5, SagayAS3,6, Okonkwo P7 and Kanki P4*

1Department of Medicine, University of Jos/ Jos University Teaching Hospital, Jos. Nigeria

2Department of Paediatrics, University of Jos/ Jos University Teaching Hospital, Jos, Nigeria

3AIDS Prevention Initiative in Nigeria (APIN), Jos University Teaching Hospital, Jos, Nigeria

4Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA

5Department of Family Medicine, University of Jos/ Jos University Teaching Hospital, Jos, Nigeria

6Department of Obstetrics and Gynaecology, University of Jos/ Jos University Teaching Hospital, Jos, Nigeria

7AIDS Prevention Initiative in Nigeria (APIN) Ltd GTE, Abuja, Nigeria

#contributed equally and share first authorship

*Corresponding Author:
Phyllis Kanki
Department of Immunology and Infectious Diseases
Harvard School of Public Health
651 Huntington Avenue, Boston, MA, USA
E-mail: [email protected]

Received Date: June 18, 2013; Accepted Date: July 19, 2013; Published Date: July 25, 2013

Citation: Agbaji O, Ebonyi AO, Meloni ST, Anejo-Okopi JA, Akanbi MO, et al. (2013) Factors Associated With Pulmonary Tuberculosis-HIV Co-Infection in Treatment- Naive Adults in Jos, North Central Nigeria. J AIDS Clin Res 4:222. doi:10.4172/2155-6113.1000222

Copyright: © 2013 Agbaji O, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Co-infection with tuberculosis and human immunodeficiency virus (TB-HIV) remains a major global health problem, with about 1.1 million new cases of TB in HIV-positive persons reported in 2011; 79% of the reported cases were amongst patients living in Africa. Advanced immune suppression remains the most important risk factor for tuberculosis in those with HIV, but epidemiological and clinical factors have also been identified. We sought to determine the prevalence and factors associated with pulmonary tuberculosis (PTB) in antiretroviral therapy (ART)- naive HIV-infected patients seeking HIV care services at a tertiary health facility in North Central Nigeria.

Methods: We compared clinical and laboratory data for 218 HIV-1 positive adults with and without a diagnosis of pulmonary tuberculosis. Results from univariate analyses informed the selection of predictors to conduct multivariate analysis to determine which factors were associated with presence of PTB-HIV co-infection.

Results: The prevalence of PTB-HIV co-infection in the evaluated cohort was 9.6%. Lower CD4+ cell count and the presence of oropharyngeal candidiasis were independently associated with PTB-HIV co-infection. CD4+ cell count was strongly associated with PTB-HIV co-infection (p=0.002) with the odds of co-infection reduced by 85% in those with a CD4+ cell count >100 cells/mm3 compared to those with <100 cells/ mm3. There was a strong association between oropharyngeal candidiasis and PTB-HIV co-infection, where the odds of co-infection are about 4.5 times higher in those with oropharyngeal candidiasis than those without candidiasis (p=0.008).

Conclusion: PTB was prevalent among HIV patients seeking care in our setting. Severe immune suppression and oropharyngeal candidiasis were associated with PTB-HIV co-infection in our patients at presentation. Potential implications for severe immune suppression and advanced HIV disease are a poor clinical outcome and further spread of PTB. Strategies to encourage the early diagnosis of both HIV and TB should be considered

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