Comparison of CD4 counts in HIV-TB co-infection before and after anti-retroviral therapy - A prospective study


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Article type :

Original Article

Author :

Ravikanti S K, Siddaganga S M, Sunitha B R, Vishwanath G

Volume :

7

Issue :

1

Abstract :

Introduction: Tuberculosis and HIV epidemic is the most prevalent problem in both developed and developing countries. Tuberculosis is the most prevalent airborne opportunistic infection among people living with HIV. Aim: The present study aims to assess the impact of 6 months ART treatment on CD4 counts among HIV-TB co infected patients. Materials and Methods: This was a prospective longitudinal study to assess the impact of 6 months ART treatment among HIV-TB infected patients. The study duration was between August 2012-March 2013. 189 HIV with TB diagnosed patients were taken from CG Hospital, treated under NACO guidelines. Follow up of cases done after six months of duration with CD4 count. CD4 Count was done by Flow Cytometry Method and expressed as cells/ml. Results: 189 HIV-TB infected cases enrolled for the study who attended ART Centre, Among them 75(40%) were fresh diagnosed cases of HIV and TB and were started on ART therapy. 114(60%) cases were in age group 14 to 50 years with co-infection already on ART. A large number were diagnosed as having pulmonary tuberculosis (120cases). Extrapulmonary TB cases were 69 (lymphnode TB - 39, ascities-15, pleural effusion-10, CSF-5) and total 169 patients were having CD4 count of < 200> ART, CD4 count increased to more than 300. Conclusion: The clinical manifestation of TB-HIV is quite distinct exhibiting different CD4 counts. The co morbidities of HIV -TB has shown a challenge in diagnosis and treatment. HIV-TB cases have shown a decline in CD4 count without ART treatment leading to increased morbidity and mortality.

Keyword :

 Tuberculosis, Co-morbidity, HIV, ART and CD4 count.