The immunological status of newly diagnosed tuberculosis patients co-infected with human immunodeficiency virus-1 in Adama Hospital, Ethiopia.

BACKGROUND

Tuberculosis remains a public health problem in patients with human immunodeficiency virus infection in sub-Saharan Africa. Both diseases form a lethal combination, each speeding the progress of the other.

OBJECTIVE

The aim of this study was to assess the prevalence of HIV infection in newly diagnosed tuberculosis patients in Adama hospital.

METHODS

Blood and sputum samples were collected from adult newly diagnosed tuberculosis patients. Sera were screened for anti-HIV antibody using rapid HIV test kits based on the National testing algorithm. The CD4 and CD8 T-cell subsets were determined using flow cytometry and the ratio of CD4+ and CD8+ were estimated using FACScan. All sputum specimens collected on three consecutive days from patients attending the tuberculosis clinic were screened for acid fast bacilli using smear microscopy.

RESULTS

The seroprevalence of HIV among 258 patients with newly diagnosed TB was 26.4%. The median CD4 T cell count of HIV negative and HIV positive TB patients were 702 cells/mm3 and 233 cells/mm3. respectively (P < 0.05). Of the TB patients, 35.7% had extrapulmonary TB and 20% were smear-positive pulmonary TB. The CD4/CD8 ratio in HIV negative patients was 1.33 cells/mm3 compared to the 0.29 cells/mm3 in HIV positive patients. Of the 68 HIV positive TB patients. 58(85.3%) were not aware of their HIV serostatus prior to the screening in the current study.

CONCLUSION

In the current study the HIV seroprevalence was 26.4%. The median CD4 count was very low in the TB/HIV co-infected individuals than those infected with TB alone. Majority of the HIV infected individuals were not aware of their serostatus. Provider initiated HIV/AIDS counseling and testing in TB clinics should be strengthened