Prevalence and Associated Risk Factors of TB in People with HIV in Pakistani Population

Abstract

Background: Mycobacterium tuberculosis infects 1/3rd of the world’s population. The second most common cause of death globally is tuberculosis TB. It has resulted in more than 2 million deaths annually. Due to the immunodeficiency in HIV patients’ opportunistic infections can easily get through the human defence system. TB infection is among the most common opportunistic infection present in PLHIV.

Aim: To check the prevalence and associated risk factors of TB in patients having HIV in Pakistani population.

Study Design: Descriptive cross-sectional study.

Methodology: 138 patients above 18 years of age irrespective of gender, diagnosed with HIV undergoing antiretroviral therapy ART were included in the study. All the participants were screened for TB next. Following symptoms were noted current fever, cough, night sweats for more than 2 weeks, weight loss of more than 3 kg in last 4 weeks. A detailed physical examination was carried out. X-ray chest was done and findings suggestive of TB were noted. Further confirmation of TB was carried out using sputum microscopy taking spot sputum sample and the morning sputum sample. TB was further classified as pulmonary, extra pulmonary or mixed. The analysis of the data was done using SPSS 25.0.

Results: Males constituted 90(65.2%) and females were 48(34.8%). Mean age of the patients was 36.1± 12.7 years. Tb was positive in 47(34.1%) of the cases diagnosed with HIV. Tb was more prevalent among younger age group (21-40 years) in PLHIV (p=0.3). Male patients having HIV were more at risk of developing TB as compared to females (p=0.5) as the disease (HIV) progressed from mild to severe stage the risk of contracting TB increases significantly (0.001). Literacy rate and CD4+ cell count was not significant risk factors.

Practical Implication: Due to the emerging danger of the HIV, this study helped researchers investigate the risk factors associated with TB in people suffering from HIV.

Conclusion:  TB was present in 34.1% of the HIV affected individuals. The greatest risk for developing TB was among male gender with advanced stage HIV, younger age groups, those with No INH prophylaxis and a positive family history of TB.

Keywords: antiretroviral therapy (ART), Human immunodeficiency virus HIV, INH prophylaxis, tuberculosis (TB)