The effect of tuberculosis on immune reconstitution among HIV patients on highly active antiretroviral therapy in Adigrat general hospital, eastern Tigrai, Ethiopia; 2019: a retrospective follow up study (original) (raw)
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PLOS ONE, 2021
Introduction Globally, tuberculosis takes the first rank for the ill-health of people living with HIV/AIDS. Despite the favorable outcome of antiretroviral therapy, the risk of tuberculosis remains higher among HIV patients. This obliges to identify factors for its occurrence and further prevention of drug-resistant tuberculosis. There is a contradiction between different studies and studies conducted in Ethiopia studied poorly the association between adherence to antiretroviral therapy and viral load with tuberculosis. Studies conducted in the study area were limited to cross-sectional study design. Therefore, this study claimed to identify factors determining the occurrence of tuberculosis after initiation of antiretroviral therapy. Methods This study was conducted at Dessie Referral Hospital by using a case-control study design on a sample of 565 with a control: case ratio of 3:1. Participants from controls were selected by systematic random sampling and from cases by consecutive...
Journal of Health & Medical Informatics, 2014
Background: Study done in Ethiopia in Southern Nation Nationality People (SNNP) during 2003 showed the incidence of TB among those on HAART was lower (3.70 cases of TB per 100 person years) than those, on pre-HAART (11.1 cases of TB per 100 PYO). Besides being on HAART or pre HAART different socio demographic, substance use and clinical factors play an important role in developing TB infection among PLHIV. So, the objective of this study was to assess the effect of HAART on incidence of TB among people living with HIV/AIDS. 1.2 Methods: A retrospective cohort study was conducted at Assela referral Hospital among patients enrolled on HIV care and support during September 13/2005 to January 30/2011. A total of 412 patients' record from the HAART and pre HAART group were selected in one to one ratio by simple random sampling method. Kaplan Meier and proportional cox regression methods were used to determine the predictor of TB incidence. Result: The incidence of tuberculosis was 7.02/100 person years (95% CI: 5.02, 9.83) among those on pre HAART follow up where as it was 3.73/100 person years among those on HAART. Furthermore, individuals on HAART have a 96.8% decrease in risk of tuberculosis, (AHR=0.032; 95% CI: 0.012, 0.082) than those non-HAART individuals. Similarly CD4 cell count <200 cell/µl and WHO clinical stage III or IV has statistically significant association with TB development among People living with HIV/AIDS. Conclusion and recommendation: HAART use decreased tuberculosis incidence among HIV positive individuals. In addition, CD4 cell count <200 cell/µl and WHO clinical stage III or IV were factors associated with the development of new TB cases among PLHIV. So, HAART should be started with a higher CD4 cell count and none advanced WHO clinical stage in order to get maximum reduction of new TB cases among PLHIV.
BMC Public Health
Background Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of f...
PLOS ONE
Background In resource-limited countries such as Ethiopia, tuberculosis is the major cause of morbidity and mortality among people living with the human immunodeficiency virus. In the era of antiretroviral therapy, the effect of tuberculosis on the survival of patients who are living with human immunodeficiency virus has been poorly understood in Ethiopia. Therefore, this study aimed to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy in public hospitals in Eastern Ethiopia. Methods An institution-based retrospective cohort study was conducted among 566 participants from January 1, 2014, to June 30, 2018. The collected data were entered into EpiData version 3.1 before being exported to Stata version 14 for analysis. A Cox proportional hazard model was used to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy, and a p-value less ...
Tropical Medicine and International Health, 2012
objectives To investigate whether an unrecognised diagnosis of tuberculosis (TB) at the start of antiretroviral therapy (ART) influences subsequent CD4+ T cell (CD4) count recovery in an urban HIV clinic in Uganda. methods In a retrospective cohort study, a multivariable polynomial mixed effects model was used to estimate CD4 recovery in the first 96 weeks of ART in two groups of patients: prevalent TB (started ART while on TB treatment), unrecognised TB (developed TB within 6 months after start ART). results Included were 511 patients with a median baseline CD4 count of 57 cells ⁄ mm 3 (interquartile range: 22-130), of whom 368 (72%) had prevalent TB and 143 (28%) had unrecognised TB. Compared with prevalent TB, unrecognised TB was associated with lower CD4 count recovery at 96 weeks:)22.3 cells ⁄ mm 3 (95% confidence interval)43.2 to)1.5, P = 0.036). These estimates were adjusted for gender, age, baseline CD4 count and the use of zidovudine-based regimen. conclusions Unrecognised TB at the time of ART initiation resulted in impaired CD4 recovery compared with TB treated before ART initiation. More vigilant screening with more sensitive and rapid TB diagnostics prior to ART initiation is needed to decrease the risk of ART-associated TB and sub-optimal immune reconstitution.