Stoian Andreea Cristina 1, Niculescu Irina 1, Cupșa A. 1, Dumitrescu Florentina 1, Iocu Cristina 2, Giubelan L. 1, Marinescu Liliana 2
1 University of Medicine and Pharmacy from Craiova
2 “Victor Babes” Infectious Diseases Hospital from Craiova
Abstract
Objectives: To identify risk factors for tuberculosis (TB) in patients with HIV/AIDS (PIH), through a retrospective study. Methods: A retrospective study compared the period 01/01/2006- 31/12/2010 on two groups of PIH born between 1987-1990, horizontally infected with HIV in early childhood and ARV treatment: group A-16 PIH diagnosed with TB in 2010 and lot B-46 PIH without opportunistic infections at the time of inclusion in the lot (2010). Results: Demographics: group A-9M/7F; 7R/9U, median age = 20 years and group B-22M/24 F, 18 R/28U, median age = 21 years. Average BMI (kg/m²) in group A vs group B was: in T3-22.22 ± 4.18 vs 23.19 ± 3.99 (p=0.44) at T2-21.78±3.21 vs 22.43±3.78 (p=0,54) and T1-17,44±3,01 vs 22,11±4,18 (p=0.0001). Adherence of 95-100% (score 19-20) to ARV therapy was found in group A vs group B: the T3- 8 (53.33%) PIH vs 39 (84.78%) PIH (p=0.005; RR=3.29); the T2-7(43.75%) PIH vs 41 (89.13%) PIH ( p=0.0005; RR=5.18) and T1-9 (56.25%) PIH vs T3-44 (95.65%) PIH (p=0.001; RR=4.58). Average CD4 (cells/mm ³) in group A vs group B was: to the T3-331.09±182.54 vs 658.09±332.2 (p=0.0001), at T2-173±113.89 vs 616.3±377.16 (p=0.0004) and at T1- 103.82±53.21 vs 682.5±388.22 (p=0.0001). Average HIV-VL (copies/ml) in group A vs group B, was: to the T3-7893.23±2839.63 vs 2123.2±623.83 (p=0.0001), at T2-24790.25±7653.87 vs 954.71±224.33 (p=0.0001) and at T1-99520.97±24745.52 vs 78.43 ± 29.21 (p=0.0001). AIDS related clinical events were found in group A, 5 PIH (31.25%) and in group B, 2 PIH (4.34%) (p=0.03; RR=3.57). Conclusions: Identified risk factors for TB in PIH were downward evolutionary trend of CD4 cell count and upward of HIV-VL, within the 5 years before detection of these infections and AIDS related clinical events (nonTB), within 3 years before TB diagnosis, with poor adherence at ARV therapy.