Tuberculosis among People living with Human Immunodeficiency Virus at Tertiary Care Hospital, Kathmandu, Nepal

Paudel P**, Shakya SK*, Dangol NM**,

Abstract


INTRODUCTION: Tuberculosis is most frequently diagnosed opportunistic infection among People living with
HIV (PLHIV). It is the leading cause of death and hospitalization among PLHIV worldwide causing one fourth
to one third deaths mostly in developing countries. Intensified case finding to detect and treat the TB as
early as possible and initiation of Antiretroviral Therapy earlier has proven positive impact by significantly
reducing morbidity and mortality in TB- HIV co-infection thereby improving survival period and quality of life.
An integrated approach of TB-HIV treatment program has resulted in excellent adherence making high rate
of cure of TB with least chance of development of Multidrug resistant Tuberculosis.
METHOD: This is a retrospective study performed on all PLHIV registered in ART clinic of OPD of NAMS, Bir
hospital from 7th Jan 2011 to till 31st January 2015. The clients’ personal file and main OPD register reviewed
to extract necessary data. The data were analyzed by using simple statistical methods, SPSS and EPI – info
statistical program.
RESULT: Out of all total 191 PLHIV registered in ART clinic 185 were eligible for ART and all included in this
study. Regarding mode of transmission Heterosexual were 55%, Injecting Drug Users 31.95%, Homosexual
7.3%, and other (vertical) 4.7%. Regarding gender ratio 20 (64.5%) were male, 8(25.8%) were female and
3(9.7%) were Trans gender. Out of them 31 (16.2%) PLHIV were infected with tuberculosis and among them
20 (64.5%) were Pulmonary Tuberculosis and 11(35.5%) were extra pulmonary Tuberculosis.
CONCLUSION: In regards to high rates of prevalence of Tuberculosis in PLHIV the appropriate measures are
necessary to be undertaken which include intensified case finding of TB, early diagnosis and treatment of
TB and Isoniazid prevention therapy is required to reduce morbidity and mortality related with TB-HIV coinfection. To achieve this goal TB and HIV program should work in collaborative approach.

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