alexa Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India.
Biomedical Sciences

Biomedical Sciences

Journal of Bioengineering & Biomedical Science

Author(s): Sharma SK, Soneja M, Prasad KT, Ranjan S

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Abstract BACKGROUND & OBJECTIVES: There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. This study was done to assess the frequency and pattern of TB, outcome of anti-tuberculosis treatment, and the factors related to poor outcome of TB treatment in adult patients with HIV infection. METHODS: Retrospective review of case records of HIV-TB co-infected patients attending the antiretroviral therapy (ART) clinic in a tertiary care centre in north India was done. RESULTS: Of the 1754 patients included in the study, 583 (33.2\%) were diagnosed with active TB and 466 (79.9\%) of them had CD4 count less than 200/΅l at diagnosis. Extrapulmonary TB was diagnosed in 372 (63.8\%) patients [76 (20.4\%) had disseminated TB], and pulmonary TB in 211 (36.2\%) patients. "Favourable outcome" (cure and completed treatment) was observed in 332 (77\%) patients. Unfavourable outcome included default (8.1\%), treatment failure (1.6\%), and death (13.2\%). At 1-year post-treatment follow up, 12 (3.6\%) patients had disease relapse. CD4 count of less than 200/ ΅l at diagnosis [OR-2.32, CI (1.06-5.09)], and retreatment cases [OR-2.91, CI (1.22-6.89)] were independent predictors of unfavourable outcome. INTERPRETATION & CONCLUSIONS: There is an urgent need to strengthen the information, education, communication activities and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB. The findings highlight the need for performing drug susceptibility testing (DST) for patients starting retreatment regimen to improve treatment outcome.
This article was published in Indian J Med Res and referenced in Journal of Bioengineering & Biomedical Science

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