Molecular detection of pulmonary tuberculosis and Candida albicans co-infection in people living with HIV/AIDS in Nigeria.

OBJECTIVES

Concurrent pulmonary tuberculosis (PTB) and antifungal-resistant candidiasis pose significant clinical and public challenges in resource-limited settings. This study determined the prevalence of PTB and antifungal-resistant Candida albicans co-infection among people living with HIV/AIDS (PLWHA) in Gombe State, Nigeria.

METHODS

Sputum samples from 348 PLWHA were processed and tested for Mycobacterium tuberculosis using GeneXpert equipment. Moreover, C. albicans was isolated and identified using CHROMagar, germ tube test, and 18S rRNA-ITS-PCR sequencing, and its antifungal susceptibility patterns were determined by the disc diffusion method.

RESULTS

The prevalence values for C. albicans, PTB, and C. albicans-PTB co-infections were 9.2%, 9.2%, and 6.3%, respectively. All Mycobacterium tuberculosis strains were rifampicin-susceptible but were significantly associated with age (P = .0033) and biological sex (P = .03). About 40.6%, 31.3%, and 28.1% of the C. albicans strains were resistant to fluconazole, voriconazole, and amphotericin-B, respectively. PLWHA aged >60 years had significantly higher odds of C. albicans infection (OR = 54.6, P = .0156). History of antibiotic use, pet ownership, and presence of PTB were significantly associated with C. albicans (P < .05). About 87.5% of PLWHA with C. albicans had CD4⁺ T-cell counts of <200 cells/mm³.

CONCLUSION

The levels of PTB and C. albicans mono- or co-infections among PLWHA were moderate, with a high frequency of fluconazole-resistant C. albicans. This study provided updated local surveillance data on pulmonary infections among PLWHA.