SURVIVAL PATTERN OF TB/HIV PATIENTS ON TREATMENT AT FEDERAL MEDICAL CENTRE, IDO-EKITI, EKITI STATE, NIGERIA

Abstract

Tuberculosis (TB) and HIV co-infection remains a major public health concern worldwide. In spite of different initiatives implemented to tackle the disease, many countries have not reached TB control targets. One of the major reasons for this failure is attributed to its relationship with HIV infection. The aim of this project is to evaluate effect of ART on the survival of TB patients with HIV co-infection. A retrospective cohort study was conducted to compare the survival between HIV/TB patients with and without ART treatment during a twenty-four month ART period. HIV/TB patients' status was ascertained and followed up for a period of 24months. Death was taken as an outcome of interest. All patients with HIV/TB treatment outcomes other than death were considered as censored. Cox proportional, hazard regression model was used to determine the hazard ratio (HR) of death for each baseline predictor. Three hundred and forty - four TB/HIV co-infected patients were followed up for a period of 24months. Two hundred and eighteen HIV/TB co- infected patients were on ART while one hundred and twenty-six HIV/TB co infected patients were on Cotriomoxazole prophylaxis therapy (Non ART) as the control group. Sixty-seven HIV /TB co- infected patients death occur at the end of the follow up study. Thirty patients were from ART group while the remaining Thirty- seven patients were from Cotriomoxazole group. HIV /TB co-infection patients not on ART were two times more likely to die than those on ART after adjusting for other variables, (adjusted Hazard Ratio (AHR) =1.65, p = 0.013). HIV/TB patients who were not on ART had shorter survival time (Log rank test= 17.34, df= 1, p< 0.001). Mortality was substantially higher among HIV/TB co- infected patients who were on Cotriomoxazole prophylaxis therapy, especially during the intensive phase. Higher death rate was demonstrated in HIV /TB patients with CD4 counts less than 200. Targeted and comprehensive management of TB and HIV with a strict follow up should be considered through the entire TB and HIV treatment period.