Skip to content
1887

Access Microbiology open research platform logo Access Microbiology

Volume 7, Issue 8

A hospital-based observational study on HIV-TB co-infection Open Access

Abstract

Human immunodeficiency virus (HIV) is the major cause of failure to reach targets of tuberculosis (TB) control in settings with high HIV loads. TB, on the other hand, enhances the progression of HIV infection to AIDS. This study was done to understand the epidemiological and clinical profile of HIV-TB co-infected patients and to study the impact of TB on the recovery of CD4 counts.

An observational study was conducted in which of the 573 patients newly diagnosed with HIV infection and enrolled at the antiretroviral therapy (ART) centre, King George’s Medical University, Lucknow, between May 2021 and June 2022, 80 patients who also had newly diagnosed TB were included. These HIV-TB co-infected patients were analysed for demographic factors. Also, clusters of differentiation 4 (CD4) counts were done at the time of enrolment on ART and then later, ~6 to 8 months of recieving ART and anti-tubercular treatment (ATT) initiation. For comparison, of the 493 HIV-only patients, 50 age- and gender-matched consecutive patients for whom baseline and follow-up CD4 counts were available were enrolled as controls. The change from baseline CD4 count was calculated using a paired t-test and Wilcoxon signed rank test.

In the present study, among HIV-TB co-infected patients, baseline CD4 levels were 194.52±162.27, and follow-up CD4 levels were 285.09±170.33. A statistically significant increment of 90.57±165.60 in mean CD4 levels was observed (=4.019; <0.001). Likewise, in only HIV-positive patients, a statistically significant increment of 125.26±191.48 (35.75%) cells in mean CD4 levels was observed (=4.626; <0.001). The increase in CD4 counts in HIV only population was significantly higher than that observed in HIV-TB co0infected patients.

Though significant rise in CD4 counts was observed in both HIV-TB co-infected patients and HIV-only patients after 6 to 8 months of appropriate therapy, the rise was significantly higher among the HIV-only group as compared to the HIV-TB co-infected group.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): anti retroviral therapy , anti-tubercular treatment , CD4 counts , co-infection , human immunodeficiency virus (HIV) and tuberculosis
© 2025 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000787.v4
2025-08-06
2026-03-09

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/acmi/7/8/acmi000787.v4.html?itemId=/content/journal/acmi/10.1099/acmi.0.000787.v4&mimeType=html&fmt=ahah

References

  1. Corbet EL, Watt CJ, Walker N et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003; 163:1009–1021 [View Article]
     [Google Scholar]
  2. World Health Organization Key facts HIV; 2022Jul https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/key-facts-hiv-2021-26july2022.pdf?sfvrsn=8f4e7c93_5 accessed 29 June 2022
  3. World Health Organization Provisional tuberculosis (TB) notifications; 2023 https://worldhealthorg.shinyapps.io/tb_pronto/ accessed 29 June 2023
  4. Ministry of Health and Family Welfare Government of India India TB report 2022. https://tbcindia.mohfw.gov.in/wp-content/uploads/2023/05/TBAnnaulReport2022.pdf accessed 29 June 2023
  5. World Health Organization Key facts Tuberculosis; 2023 https://www.who.int/news-room/fact-sheets/detail/tuberculosis accessed 29 June 2023
  6. Ahmad S. New approaches in the diagnosis and treatment of latent tuberculosis infection. Respir Res 2010; 11:1–7 [View Article]
     [Google Scholar]
  7. Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema C et al. The twin epidemics: prevalence of TB/HIV co-infection and its associated factors in Ethiopia; a systematic review and meta-analysis. PLoS One 2018; 13:e0203986 [View Article] [PubMed]
     [Google Scholar]
  8. Gautam L, Deshpande JD, Somasundaram KV. Prevalence of HIV-TB co-infection, clinical profile and CD4 count of HIV patients attending ART centre of Ahmednagar, Maharashtra. Int J Med Sci Public Health 2014; 3:1105 [View Article]
     [Google Scholar]
  9. Kamath R, Sharma V, Pattanshetty S, Hegde MB, Chandrasekaran V. HIV-TB coinfection: clinico-epidemiological determinants at an antiretroviral therapy center in Southern India. Lung India 2013; 30:302–306 [View Article] [PubMed]
     [Google Scholar]
  10. Parrikar A, Lawande D, Cacodcar J. A study of HIV-TB co-infection and its determinants at a tertiary care hospital in Goa. IJCMR 2020; 7:F1–F6 [View Article]
     [Google Scholar]
  11. Riou C, Tanko RF, Soares AP, Masson L, Werner L et al. Restoration of CD4+ responses to copathogens in HIV-infected individuals on antiretroviral therapy is dependent on T cell memory phenotype. J Immunol 2015; 195:2273–2281 [View Article]
     [Google Scholar]
  12. National AIDS control organisationMinistry of Health Government of India National guidelines for HIV care and treatment; 2021 https://naco.gov.in/sites/default/files/National_Guidelines_for_HIV_Care_and_Treatment_2021.pdf accessed 29 June 2023
  13. Gesesew H, Tsehaineh B, Massa D, Tesfay A, Kahsay H et al. The role of social determinants on tuberculosis/HIV co-infection mortality in southwest Ethiopia: a retrospective cohort study. BMC Res Notes 2016; 9:89 [View Article] [PubMed]
     [Google Scholar]
  14. Sube KL, Seriano OF, Jajaa S, Gore RP, Loro RL et al. HIV and TB co-infection in south sudan: a three year retrospective study. S Sudan Med J 2014; 7:86–90
     [Google Scholar]
  15. Prabakaran J, Alagusundaram M. Pulmonary tuberculosis co-infection among HIV infected persons in and around district of Erode, Tamil Nadu, India. Int J Curr Microbiol App Sci 2013; 2:1–7
     [Google Scholar]
  16. Lawn SD, Zumla AI. Diagnosis of extrapulmonary tuberculosis using the Xpert(®) MTB/RIF assay. Expert Rev Anti Infect Ther 2012; 10:631–635 [View Article] [PubMed]
     [Google Scholar]
  17. Broger T, Sossen B, du Toit E, Kerkhoff AD, Schutz C et al. Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study. Lancet Infect Dis 2019; 19:852–861 [View Article] [PubMed]
     [Google Scholar]
  18. Wanchu A, Kuttiatt VS, Sharma A, Singh S, Varma S. CD4 cell count recovery in HIV/TB co-infected patients versus TB uninfected HIV patients. Indian J Pathol Microbiol 2010; 53:745–749 [View Article] [PubMed]
     [Google Scholar]
  19. Shivakoti R, Sharma D, Mamoon G, Pham K. Association of HIV infection with extrapulmonary tuberculosis: a systematic review. Infection 2017; 45:11–21 [View Article] [PubMed]
     [Google Scholar]
  20. Carvalho BM, Monteiro AJ, Pires Neto RD, Grangeiro TB, Frota CC. Factors related to HIV/tuberculosis coinfection in a Brazilian reference hospital. Braz J Infect Dis 2008; 12:281–286 [View Article] [PubMed]
     [Google Scholar]
  21. De Oliveira LB, Costar CR, Queiroz AA et al. Epidemiological analysis of tuberculosis/HIV coinfection. Cogitare Enferm 2018; 23:e51016 [View Article]
     [Google Scholar]
  22. Stop TB Partnership A rapid assessment of gender and tuberculosis in India; 2018 https://stoptb.org/assets/documents/communities/CRG/TB%20Gender%20Assessment%20India.pdf accessed 29 June 2023
  23. ADBInstitute Social factors affecting women’s susceptibility to HIV in India; 2014Jun https://www.adb.org/sites/default/files/publication/156340/adbi-wp485.pdf
  24. Mekonnen D, Derbie A, Desalegn E. TB/HIV co-infections and associated factors among patients on directly observed treatment short course in Northeastern Ethiopia: a 4 years retrospective study. BMC Res Notes 2015; 8:666 [View Article] [PubMed]
     [Google Scholar]
  25. Alemu A, Wubie Aycheh M, Dilnessa T. Tuberculosis and human immunodeficiency virus co-infection and associated factors at debre markos comprehensive specialized hospital, northwest ethiopia: a four-year retrospective study. HIV 2021; Volume 13:293–299 [View Article]
     [Google Scholar]
  26. Adhikari N, Bhattarai RB, Basnet R, Joshi LR, Tinkari BS et al. Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal. PLoS One 2022; 17:e0262720 [View Article] [PubMed]
     [Google Scholar]
  27. Fite RO, Chichiabellu TY, Demissie BW, Hanfore L. Tuberculosis and HIV Co-infection and associated factors among HIV reactive patients in Ethiopia. J Nurs Midwifery Sci 2019; 6:15 [View Article]
     [Google Scholar]
  28. Birara Aychiluhm S, Mohammed E, Altaye H, Urgessa K, Mare KU et al. Tuberculosis co-infection and associated factors among people living with HIV/AIDS who are on antiretroviral therapy in pastoral community, northeast ethiopia. A bayesian analysis approach. Cogent Educ 2022; 9:2145700 [View Article]
     [Google Scholar]
  29. Pondei K, Lawani E. Human immunodeficiency virus and pulmonary tuberculosis co-infection: need for co-ordinated collaborative detection and treatment services. Int J Med Med Sci 2013107–111
     [Google Scholar]
  30. Ku NS, Oh JO, Shin SY, Kim SB, Kim H et al. Effects of tuberculosis on the kinetics of CD4(+) T cell count among HIV-infected patients who initiated antiretroviral therapy early after tuberculosis treatment. AIDS Res Hum Retroviruses 2013; 29:226–230 [View Article] [PubMed]
     [Google Scholar]
/content/journal/acmi/10.1099/acmi.0.000787.v4
Loading
A hospital-based observational study on HIV-TB co-infection
Access Microbiology 7, 000787.v4 (2025); https://doi.org/10.1099/acmi.0.000787.v4
/content/journal/acmi/10.1099/acmi.0.000787.v4
/content/journal/acmi/10.1099/acmi.0.000787.v4
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An error occurred
Approval was partially successful, following selected items could not be processed due to error