Publication:

Impact of human immunodeficiency virus on category I pulmonary tuberculosis cases in a tertiary care hospital: a case control study

Background Tuberculosis (TB) is an opportunistic infection (OI). OIs are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. Human immunodeficiency virus (HIV) weakens the immune system, increasing the risk of TB in people with HIV. This case control study was done to assess the impact of HIV on clinical aspects and treatment outcome of newly diagnosed bacteriologically positive pulmonary tuberculosis.

Methods This study was done among unmatched 75 cases and 75 controls who were pulmonary TB and TBHIV co-infected patients. Data were collected using a pretested, structured, interviewer-administered questionnaire and was analyzed using descriptive and analytical statistics.

Results Total 150 patients were enrolled in the study out of which 75 patients had HIV-TB co-infection while remaining 75 patients were diagnosed as pulmonary TB. Treatment success rates are 74.7 % (56/75) for TB-HIV co-infected patients and 82.7% (62/75) for pulmonary TB patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome [(p = 0.232) with OR and 95% CI of 0.68 (0.28-1.36)]. The risk of unsuccessful treatment outcome was associated with family history of TB, Tobacco use, low BMI.

Conclusions TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, tobacco use, low BMI, <200 /mm3 CD4 count patients. Therefore, due emphasis should be given to these high-risk groups.