# A hospital-based observational study on HIV-TB co-infection

## TL;DR

This study compares CD4 count recovery in HIV-TB co-infected patients and HIV-only patients, finding that HIV-only patients had a greater increase in CD4 counts after treatment.

## Contribution

The study provides new empirical evidence on the differential impact of TB co-infection on CD4 recovery in HIV patients.

## Key findings

- HIV-TB co-infected patients showed a significant increase in CD4 counts after treatment.
- HIV-only patients had a significantly higher CD4 count increase compared to co-infected patients.
- Both groups showed statistically significant improvements in CD4 counts after 6-8 months of therapy.

## Abstract

Background. Human immunodeficiency virus (HIV) is the major cause of failure to reach targets of tuberculosis (TB) control in settings with high HIV loads. TB, on the other hand, enhances the progression of HIV infection to AIDS. This study was done to understand the epidemiological and clinical profile of HIV-TB co-infected patients and to study the impact of TB on the recovery of CD4 counts.

Methodology. An observational study was conducted in which of the 573 patients newly diagnosed with HIV infection and enrolled at the antiretroviral therapy (ART) centre, King George’s Medical University, Lucknow, between May 2021 and June 2022, 80 patients who also had newly diagnosed TB were included. These HIV-TB co-infected patients were analysed for demographic factors. Also, clusters of differentiation 4 (CD4) counts were done at the time of enrolment on ART and then later, ~6 to 8 months of recieving ART and anti-tubercular treatment (ATT) initiation. For comparison, of the 493 HIV-only patients, 50 age- and gender-matched consecutive patients for whom baseline and follow-up CD4 counts were available were enrolled as controls. The change from baseline CD4 count was calculated using a paired t-test and Wilcoxon signed rank test.

Results. In the present study, among HIV-TB co-infected patients, baseline CD4 levels were 194.52±162.27, and follow-up CD4 levels were 285.09±170.33. A statistically significant increment of 90.57±165.60 in mean CD4 levels was observed (t=4.019; P<0.001). Likewise, in only HIV-positive patients, a statistically significant increment of 125.26±191.48 (35.75%) cells in mean CD4 levels was observed (t=4.626; P<0.001). The increase in CD4 counts in HIV only population was significantly higher than that observed in HIV-TB co0infected patients.

Conclusion. Though significant rise in CD4 counts was observed in both HIV-TB co-infected patients and HIV-only patients after 6 to 8 months of appropriate therapy, the rise was significantly higher among the HIV-only group as compared to the HIV-TB co-infected group.