AEGiS-15IAC: To study efficacy of DOTS in TB patients with HIV coinfection.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

To study efficacy of DOTS in TB patients with HIV coinfection.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10158)

Bajaj L, Saini A, Dubey G, Ranjan R
Institution, Bellary, Karnataka, India

BACKGROUND: HIV inection has emerged as the most important predisposing factor for developing overt TB in people co-infected with M. tuberculosis. Many of these patients seek help in TB sanatoriums. Although anti retro-viral therapy (ART) is not available to most of them but DOTS is freely available in India under RNTCP. This paper aims to study the feasibility of DOTS in these patients and to study prevalence of other oppurtunistic infections in them.

METHODS: 62 patients with HIV and TB were given all doses under supervision during initial intensive phase and through community DOTS providers in continuation phase. No anti-retroviral therapy could be made available to them because of paucity of funds. TB was diagnosed on basis of clinical features, sputum smear and chest skiagram and HIV by two tests (rapid/ELISA) detecting different antigens. Assessment of improvement was based on weight gain, Hb% improvement,sputum conversion and radiological improvement.

RESULTS: Sputum smear conversion rates at end of two monthswere as follows- 78%,50% and 88% in categories I,II and III respectively, indicating good initial response to DOTS. Patients also showed significant clinical improvement and weight gain. Mean weight at start of treatment was 41.5 kg, which increased to 48 kg at end of treatment. Prevalence of other oppurtunistic infections were- Oral thrush (19.3%), esophageal candidiasis(16.1%),recurrent herpes zoster(16..1%), CNS toxoplasmosis(12.9%) and chronic diarrhoea due to cyclospora(6.4%).

CONCLUSIONS: Treatment with standard anti -tuberculosis regimens using DOTS produces significant results in initial improvement of clinical condition and quality of life in patients with HIV and TB, inspite of not giving ART. However in long term without concomitant anti-retroviral therapy there is deterioration in condition of patient and progression of disease. Decentralised care is feasible option in TB patients with HIV coinfection. Treatment of associated oppurtunistic infections is also important in prolonging life of patient.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Tuberculosis, Prevalence, Infection, Mycobacterium tuberculosis, Candidiasis, Oral, Sputum, Toxoplasmosis, Cerebral, Mycobacterium avium-intracellulare Infection, India, Humans, therapy, organization & administration

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B10158