Background & objectives: There is a paucity of data from India

Background & objectives: There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. [76 (20.4%) had disseminated TB] and pulmonary TB in 211 (36.2%) patients. Favourable outcome (cure and completed treatment) was observed in 332 (77%) patients. Unfavourable outcome included default (8.1%) treatment failure (1.6%) and death (13.2%). At 1-year post-treatment follow up 12 (3.6%) patients had disease relapse. CD4 count of less than 200/μl at diagnosis [OR-2.32 CI (1.06-5.09)] and retreatment cases [OR-2.91 CI (1.22-6.89)] were independent predictors of unfavourable outcome. Interpretation & conclusions: There is an urgent need to strengthen the information education communication activities and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB. The findings highlight the need for performing drug susceptibility testing (DST) for patients starting retreatment regimen to improve treatment outcome. Skepinone-L <0.01 in univariate analysis were included for logistic regression model. All tests were two-sided and <0.05 was considered significant. All analyses were done using SPSS (version 17) (SPSS Inc. USA). Results Of the 2612 Skepinone-L patients registered in the clinic during the study period 1754 met the inclusion criteria. HIV-TB co-infection was diagnosed in 583 (33.2%) patients. Active TB at diagnosis of HIV was present in 538 (30.7%) while 45 (2.6%) patients were diagnosed with TB while on HAART. The demographic clinical and laboratory profile of these patients are shown in Table I. EPTB was diagnosed in 372 (63.8%) patients [76 (20.4%) had disseminated TB]; whereas pulmonary TB was diagnosed in 211(36.2%) patients. The disease classification and the CD4 counts are shown in Table II. There was Skepinone-L no significant difference in median CD4 counts between patients with PTB and EPTB. ATT related adverse events were reported in 100 (17.1%) patients; drug induced hepatitis (DIH) observed in 93 (15.9%) patients was the commonest adverse event. Table I Demographic clinical and laboratory GDNF profile of HIV-infected patients with (n=583) and without TB (n=1171) Table II Disease classification and CD4 counts in HIV-infected patients with TB (n=583) TB treatment outcome in 431 patients is shown in Table III. For the assessment; 124 patients who were either on treatment or had completed treatment but had less than 12 months follow-up and 28 patients who had complete baseline evaluation but were transferred out to their respective local ART centres were excluded Skepinone-L from analysis (Figure). “Favourable outcome” was observed in 332 (77%) patients; 122 (75.3%) having PTB and 210 (78%) having EPTB. Among PTB patients sputum positives had lower success rate compared to sputum negative group (70.9 vs 77.6%); mainly attributed to higher rates of default among patients with sputum positive PTB. At 1-year post-treatment follow up 12 (3.6%) patients had disease relapse. Table III Treatment outcomes of TB in HIV-infected patients (n=431) Fig. Flow chart showing the study profile. The variables compared between the groups with “favourable” and “unfavourable” outcomes were CD4 counts disease classification (PTB/EPTB) sputum smear status in PTB patients type of patient (retreatment/new) ATT type (DOTS/daily therapy) ATT related side effects and initiation of ART at the time of diagnosis of TB (ART na?ve/on ART). Table IV shows the univariate analysis of various factors; the associations with <0.01 were included in the Skepinone-L logistic regression model. In the logistic regression analysis factors independently associated with poor outcome were ‘CD4 count <200/μl [aOR 2.32 CI (1.06-5.09)] and ‘retreatment’ [aOR 2.91 CI (1.22-6.89)]. Table IV Univariate and multivariate analysis of factors associated with poor TB treatment outcome Skepinone-L (n=431) Discussion TB was diagnosed in 33.2 per cent patients with HIV infection. The estimated annual risk of reactivation among those co-infected with HIV and TB is about 5 to 8 per cent with a cumulative lifetime risk of 30 per cent or more; compared to a cumulative.