Treatment Outcome Analysis of Drug-Sensitive Pulmonary and Extrapulmonary Tuberculosis Among HIV Positive and HIV Negative Patients and their Correlation with CD4 Counts

Abstract

Background: WHO guidelines recommended daily therapy in HIV-TB co-infected individuals. The study was aimed at comparing treatment outcomes of standard drug-sensitive anti-tuberculosis regimen in HIV seropositive and HIV seronegative patients with tuberculosis and their correlation with CD4 counts.
Material & methods: The present observational and prospective study of 236 HIV-negative and 154 HIV-positive patients was conducted over two years. All the patients included in the study were reviewed regularly to enquire the compliance, symptom improvement and outcome analysis.
Results: Among HIV-negative patients, pulmonary TB was more common, while among HIV-positive patients, extrapulmonary TB was observed more frequently. Notably high treatment success rate (82.6 vs. 65.5% at the end of treatment, p-value 0.002) and low mortality rate (8.0 vs. 20.1%, p-value 0.002) were observed among HIV-negative patients. Higher CD4 counts among HIV-positive patients was found to be noteworthy after 6 months treatment (194.85 vs. 288.18, p <0.001). Those HIV individuals who died had inadequate improvement in CD4 counts.
Conclusions: Overall, HIV negative patients did better on the daily DOTS regimen than HIV positive patients in terms of treatment completion and success rates, treatment failure as well and mortality. Improvement in CD4 counts after treatment was statistically significant and indicates the effectiveness of combined ART and DOTS in tuberculosis treatment.