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Journal of the International AIDS Society

Open Access

Epidemiology of HIV-associated tuberculosis (TB) co-infection in Krasnoyarsk region, Russian Federation

  • TA Chaychuk1,
  • NU Gankina1 and
  • OG Nikonova1
Journal of the International AIDS Society201013(Suppl 4):P193

https://doi.org/10.1186/1758-2652-13-S4-P193

Published: 8 November 2010

Background

Incidence of HIV-associated tuberculosis (TB) co-infection is increasing in Krasnoyarsk region as well as in RF. Total number of registered TB/HIV new cases has increased from 7 in 2000 to 170 in 2009. Mortality rate of patients with HIV/TB co-infection has increased: 2004-7 cases, 2008-40, 2009-48. On January 1st, 2010 we have 407 TB/HIV co-infected patients, which makes 6% from the HIV+ patients under supervision (n=6801) in our region.

Methods

A retrospective chart review was conducted on HIV-positive patients diagnosed with TB in 2009. All patients were HIV-positive and had confirmed diagnosis of mycobacterial tuberculosis, or clinically presumptive diagnosis of TB with response to anti-tuberculosis therapy.

Summary of results

A total of 170 HIV/TB co-infection patients were identified. The general characteristics of the patients are: male (75%), median age 28 years old [1;55] when HIV has been diagnosed and 33 years old [5;56] at the time of TB diagnosis. HIV was acquired vertically - 0,6%, sexually in 22% of the cases, and through intravenous drug injections - 74%. At the time of TB diagnosis, 70 (40%) had a CD4 count of less than 200. 23% had a baseline HIV viral load greater than 100,000 copies/ml, median VL were 338787 copies/ml. 9,4% of cases had a history of TB prior to HIV diagnosis. 14% had TB as the primary AIDS-defining event; 82 patients (48%) had pulmonary disease, 47 patients (28%) presented with extra-pulmonary disease and of these, 22 (13%) had disseminated disease. 28% cases had extra-pulmonary TB involvement and are related to lower CD4 count (median 189/uL vs. 388/µL, p<0.001), and mortality rate. 28 patients (16,5%) had multi-drug resistant TB. 16,5% patients received antiretroviral treatment (ARV) at the time of TB diagnosis. Anti-TB treatment was associated with ARV on 39% (6% PI and 33% NNRTI). Out of 170 HIV/TB patients 35 (21%) were died. Risk of death is related to severity of immunosuppression and TB diagnostic time (median CD4 count 353 in survivors vs 79 in dead, p<0.001). The chronic hepatitis C was found in 69% of patients with HIV/TB infections.

Conclusions

1. HIV/TB co-infection has a high incidence rate due to delayed verification of TB infection, as a result the prognosis is poor; 2. Risk factors for such patients are low CD4 cell count and extra-pulmonary involvement; 3. The high prevalence of the chronic hepatitis C causes the hepatotoxicity increasing during ART and antitubercular therapy for patients with HIV/TB infections.

Authors’ Affiliations

(1)
Regional Center of AIDS Prevention, consultative and treatment of patients with HIV

Copyright

© Chaychuk et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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