https://doi.org/10.4081/monaldi.2022.2405
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
Submitted: August 11, 2022
Accepted: September 27, 2022
Published: October 5, 2022
Accepted: September 27, 2022
Abstract Views: 1236
PDF: 270
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
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.
World Health Organization. Global Tuberculosis Report, 2021. Available from: https://www.who.int/publications/i/item/9789240037021
Central TB Division, Ministry of Health and Family Welfare, Government of India. India TB Report 2022. Accessed: 2022 Sep 22. Available from: https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport2022.pdf
World Health Organization. WHO policy on collaborative TB/HIV activities: guidelines for national programmes and other stakeholders. Accessed: 2022 Feb 21. Available from: https://www.who.int/publications/i/item/9789241503006
Prasad R, Tripathi A, Prasad R, et al. A Comparative study of clinico-radiological spectrum of tuberculosis among HIV seropositive and HIV seronegative patients. Indian J Chest Dis Allied Sci 2004;46:99-103.
Central TB Division, Ministry of Health and Family Welfare, Government of India. National Strategic Plan 2017-2025 for TB Elimination in India. 2018. Accessed: 2022 Aug 3. Available from: https://tbcindia.gov.in/index1.php?lang=1&level=2&sublinkid=5450&lid=3266
Jenks JD, Kumarasamy N, Ezhilarasi C, et al. Improved tuberculosis outcomes with daily vs. intermittent rifabutin in HIV-TB coinfected patients in India. Int J Tuberc Lung Dis 2016;20:1181–4.
DOI: https://doi.org/10.5588/ijtld.15.0997
Swaminathan S, Deivanayagam CN, Rajasekaran S, et al. Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. Natl Med J India 21:3–8.
Sinshaw Y, Alemu S, Fekadu A, Gizachew M. Successful TB treatment outcome and its associated factors among TB/HIV co-infected patients attending Gondar University Referral Hospital, Northwest Ethiopia: an institution based cross-sectional study. BMC Infect Dis 2017;17:132.
DOI: https://doi.org/10.1186/s12879-017-2238-7
Ananthan V. Modified Kuppuswamy scale for socioeconomic status of the Indian family - Update based on New CPI (IW) series from September 2020. J Family Med Prim Care 2021;10:2048.
DOI: https://doi.org/10.4103/jfmpc.jfmpc_2242_20
Thejus T, Jeeja M, Jayakrishnan T. The functional status of patients with AIDS attending antiretroviral treatment center. Indian J Palliat Care 2009;15:57–60.
DOI: https://doi.org/10.4103/0973-1075.53513
Isingo R, Żaba B, Marston M, et al. Survival after HIV infection in the pre-antiretroviral therapy era in a rural Tanzanian cohort. AIDS 2007;21:S5–13.
DOI: https://doi.org/10.1097/01.aids.0000299405.06658.a8
Chennaveerappa PK, Nagaral J, Nareshkumar MN, et al. TB-DOTS outcome in relation to HIV status: Experience in a medical college. J Clin Diagn Res 201;8:74–6.
Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res 2004;120:316–53.
Sinkala E, Gray S, Zulu I, Mudenda V, et al. Clinical and ultrasonographic features of abdominal tuberculosis in HIV positive adults in Zambia. BMC Infect Dis 2009;9:44.
DOI: https://doi.org/10.1186/1471-2334-9-44
Sculier D, Vannarith C, Pe R, Thai S, et al. Performance of abdominal ultrasound for diagnosis of tuberculosis in HIV-infected persons living in Cambodia. J Acquir Immune Defic Syndr 2010;55:500–2.
DOI: https://doi.org/10.1097/QAI.0b013e3181e6a703
Shetty N, Shemko M, Vaz M, D’Souza G. An epidemiological evaluation of risk factors for tuberculosis in South India: a matched case control study. Int J Tuberc Lung Dis 2006;10:80–6.
Djibuti M, Mirvelashvili E, Makharashvili N, Magee MJ. Household income and poor treatment outcome among patients with tuberculosis in Georgia: a cohort study. BMC Public Health 2014;14:88.
DOI: https://doi.org/10.1186/1471-2458-14-88
Hogg RS, Strathdee SA, Craib KJP, et al. Lower socioeconomic status and shorter survival following HIV infection. Lancet 1994;344:1120–4.
DOI: https://doi.org/10.1016/S0140-6736(94)90631-9
Tshikuka J, Okenge L, Lukuka A, et al. Severity of outcomes associated to illnesses funded by GFATM initiative and socio demographic and economic factors associated with HIV/AIDS, TB and malaria mortality in Kinshasa Hospitals, DRC. Ethiop J Health Sci 2014;24:299.
DOI: https://doi.org/10.4314/ejhs.v24i4.4
Gesesew H, Tsehayneh B, Massa D, et al. Predictors of mortality in a cohort of tuberculosis/HIV co-infected patients in Southwest Ethiopia. Infect Dis Poverty 2016;5:109.
DOI: https://doi.org/10.1186/s40249-016-0202-1
Alene KA, Nega A, Wasie Taye B. Incidence and predictors of tuberculosis among adult people living with human immunodeficiency virus at the University of Gondar Referral Hospital, Northwest Ethiopia. BMC Infect Dis 2013;13:292.
DOI: https://doi.org/10.1186/1471-2334-13-292
Kornfeld H, Sahukar SB, Procter-Gray E, et al. Impact of diabetes and low body mass index on tuberculosis treatment outcomes. Clin Infect Dis 2020;71:e392–8.
DOI: https://doi.org/10.1093/cid/ciaa054
Damtew B, Mengistie B, Alemayehu T. Survival and determinants of mortality in adult HIV/Aids patients initiating antiretroviral therapy in Somali Region, Eastern Ethiopia. Pan Afr Med J 2015;22:138.
DOI: https://doi.org/10.11604/pamj.2015.22.138.4352
Podewils LJ, Holtz T, Riekstina V, et al. Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients. Epidemiol Infect 2011;139:113–20.
DOI: https://doi.org/10.1017/S0950268810000907
Scrimshaw NS, SanGiovanni JP. Synergism of nutrition, infection, and immunity: an overview. Am J Clin Nutr 1997;66:464S-77S.
DOI: https://doi.org/10.1093/ajcn/66.2.464S
Kerkhoff AD, Wood R, Vogt M, Lawn SD. Predictive value of anemia for tuberculosis in HIV-infected patients in Sub-Saharan Africa. J Acquir Immune Defic Syndr 2014;66:33–40.
DOI: https://doi.org/10.1097/QAI.0000000000000091
Saathoff E, Villamor E, Mugusi F, et al. Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania. Int J Tuberc Lung Dis 2011;15:925–32.
DOI: https://doi.org/10.5588/ijtld.10.0477
Demitto FO, Araújo-Pereira M, Schmaltz CA, et al. Impact of persistent anemia on systemic inflammation and tuberculosis outcomes in persons living with HIV. Front Immunol 2020;11:588405.
DOI: https://doi.org/10.3389/fimmu.2020.588405
Matos ED, Moreira Lemos AC. Association between serum albumin levels and in-hospital deaths due to tuberculosis. Int J Tuberc Lung Dis 2006;10:1360–6.
Feldman JG, Burns DN, Gange SJ, et al. Serum albumin as a predictor of survival in HIV-infected women in the Women’s Interagency HIV study. AIDS 2000;14:863–70.
DOI: https://doi.org/10.1097/00002030-200005050-00013
Tabarsi P, Chitsaz E, Moradi A, et al. Treatment outcome, mortality and their predictors among HIV-associated tuberculosis patients. Int J STD AIDS 2012;23:e1-4.
DOI: https://doi.org/10.1258/ijsa.2009.009093
Teklu AM, Nega A, Mamuye AT, et al. Factors associated with mortality of TB/HIV co-infected patients in Ethiopia. Ethiop J Health Sci 2017;27:29.
DOI: https://doi.org/10.4314/ejhs.v27i1.4S
Vashishtha R, Mohan K, Singh B, et al. Efficacy and safety of thrice weekly DOTS in tuberculosis patients with and without HIV co-infection: an observational study. BMC Infect Dis 2013;13:468.
DOI: https://doi.org/10.1186/1471-2334-13-468
Kapadiya DJ, Dave PV, Vadera B, et al. Assessment of tuberculosis prevalence in newly diagnosed human immunodeficiency virus-infected adults attending care and treatment center in Gujarat, India. Indian J Community Med 2018;43:185-9.
Ford N, Meintjes G, Vitoria M, et al. The evolving role of CD4 cell counts in HIV care. Curr Opin HIV AIDS 2017;12:123–8.
DOI: https://doi.org/10.1097/COH.0000000000000348
Agarwal U, Kumar A, Behera D. Profile of HIV associated tuberculosis at a tertiary institute in setting of free anti-retroviral therapy. J Assoc Physicians India 2009;57:685-90.
Khan FA, Minion J, Pai M, Royce S, et al. Treatment of active tuberculosis in HIV‐coinfected patients: A systematic review and meta‐analysis. Clin Infect Dis 2010;50:128-99.
DOI: https://doi.org/10.1086/651686
How to Cite
Maji, Debapriya, Upasna Agarwal, Lokender Kumar, Vinay V, and Amit Sharma. 2022. “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”. Monaldi Archives for Chest Disease 93 (3). https://doi.org/10.4081/monaldi.2022.2405.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Lilit Khachatryan, Ruzanna Grigoryan, Andrei Dadu, Ajay M.V. Kumar, Kristina Akopyan, Kostyantyn Dumchev, Hasmik Harutyunyan, Alberto Matteelli, Factors associated with unfavourable treatment outcomes among people with rifampicin-resistant tuberculosis in Armenia, 2014-2017 , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Neeta Singla, Amitesh Gupta, U.K. Khalid, Ravindra Kumar Dewan, Rupak Singla, Clinical profile, risk factors, disease severity, and outcome for COVID-19 disease in patients with tuberculosis on treatment under the National Tuberculosis Elimination Program: a cohort of 1400 patients , Monaldi Archives for Chest Disease: Early Access
- Rupak Singla, Amitesh Gupta, Vikas Kumar, Chandrasekaran Padmapriyadarsini, Devika Tayal, Shweta Anand, Abhishek Faye, AK Hemanth Kumar, Madhumita Paul Choudhary, Study of risk factors and clinical management of patients with clinical non-response due to low plasma levels of anti-tubercular drugs , Monaldi Archives for Chest Disease: Early Access
- Alessandro Boccanelli, Pompilio Faggiano, Preoperative risk evaluation in patients over 75 years candidates to non-cardiac and cardiac surgery , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Francesco Orso, Riccardo Barucci, Stefania Fracchia, Giulio Mannarino, Alessandra Pratesi, Francesco Fattirolli, Treatment of very old patients with non valvular atrial fibrillation. The valuable opportunity offered by New Oral Anticoagulants, to be cautiously used , Monaldi Archives for Chest Disease: Vol. 80 No. 4 (2013): Cardiac Series
- Francesco Vetta, Gabriella Locorotondo, Giampaolo Vetta, Maria Mignano, Sonia Bracchitta, Prognostic impact of frailty in elderly cardiac surgery patients , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Vinay V, Sushil Kumar Munjal, Sandeep Jain, Yasir Abdullah V, Arunachalam M, Srinath Shankar Iyer, To investigate the knowledge, attitude and practices regarding tuberculosis case notification among public and private doctors practicing of modern medicine in South Delhi , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Abhay Joglekar, Subhasis Roy Choudhury, Chandra Vibhash, Manisha Kumar, Amit Gupta, Risk factors and outcome of antenatally diagnosed congenital diaphragmatic hernia following in-utero transfer in a busy public-sector tertiary care center in North India , Monaldi Archives for Chest Disease: Early Access
- W.O. Tam, C.F. Wong, P.C. Wong, Endobronchial Nocardiosis associated with Broncholithiasis , Monaldi Archives for Chest Disease: Vol. 69 No. 4 (2008): Pulmonary series
- J.A. Gullón, I. Suárez, M. Lecuona, R. Fernández, G. Rubinos, A. Medina, C. Cabrera, I. González, Time to culture conversion in smokers with pulmonary tuberculosis , Monaldi Archives for Chest Disease: Vol. 71 No. 3 (2009): Pulmonary series
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
