Risk of tuberculosis among HAART receiving HIV patients attending an ART centre of West Bengal, India: a prospective cohort study.

ABSTRACT

This prospective study was conducted to find out the incidence density rate and to identify the attributed risk factors of Tuberculosis development among ART receivers. All patients who were registered in a nodal ART centre of India within 1st January 2008-31st December 2008 and had been initiated ART in the year of 2008 were considered as a cohort and were followed up till 31st December 2012. This study was started with 169 ART receivers and ended with 129 patients. During total 631.1 person-years observation, 39 TB cases (31 pulmonary and 8 extra pulmonary) were diagnosed. TB incidence density rate reduced from 12.08/100 to 1.12/100 person-years during the follow up periods. Cox regression model revealed that patients having past history of Tuberculosis were at 5 times higher risk (Hazard ratio = 5.205; 95 % CI 2.439-11.106; p = 0.000). Patients with WHO clinical stage 3 or 4 at the time of enrolment had 2 times more risk of development of TB (Hazard ratio = 2.081; 95 % CI 1.502-2.884; p = 0.000). This study highlighted that special attention should be paid on earliest identification of TB among the HIV patients who had past history of TB or suffering from WHO clinical stage 3 or 4 to prevent the silent transmission and multidrug resistance development of Tuberculosis in the community.