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Nigerian Medical Practitioner

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Profile of HIV-1 RNA viral load among HIV-TB co-infected patients in a tertiary health facility in Maiduguri, Northeastern Nigeria

B.A. Denue, Z.W. Wuduri, M Stephen, Agwan Sati Klein, A Apagu, S Aliyu

Abstract


The overlapping epidemiology of human immunodeficiency virus (HIV) infection and tuberculosis (TB) is expected in Nigeria that is ranked 10th amongst the 22 countries that bears the burden of TB worldwide. This study aims to estimate the HIV-1 RNA viral load and impact of anti TB therapy (ATT) in a CD4 cell count matched HIV/TB co- infected and HIV infected patients. Records of 159 cohorts were randomly retrieved from a database of 15,012 patients receiving care at Harvard PEPFAR clinic, UMTH from September (2004-2014). Participants consisted of 78 HIV-TB co-infected, and 81 HIV infected patients without TB with similar CD4 cell count. Baseline mean CD4 count between the two group was similar (P=0.118). HIV-TB co infected patients had a higher baseline median ± SD (95%CI) HIV-1 RNA viral load (copies/ml) of 198,480 ± 615, 051 (52,899-344,060) than HIV positive patients without TB that had 20, 772 ± 105, 484 (2,703-44, 246), p<0.001. The reduction in mean HIV-1 RNA level was unremarkable after 6 months in response to ART/ATT among HIV/TB co-infected patients (GI), P =0.200. HIV infected patients without TB (GII) had significant reduction in mean HIV-1 RNA level p= 0.002, after 6 months of ART/ATT. Both group had a significant increase in CD 4 cell count level; it was however, more profound in GII than GI, P <0.001. HIV/TB co-infection is associated with higher HIV-1 RNA viral load among HIV patients after controlling for level of immunity. The higher HIV-1 viral load associated with active TB persists after six months of ART/ATT. We recommend timely commencement of ATT in HIV/TB co-infected patients especially in sub Saharan Africa with dearth of facility for viral load estimation.

Keywords: anti-tubercular therapy, antiretroviral therapy, HIV/TB co-infection




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