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P17.18 Factors predicting the occurrence of tuberculosis following initiation of highly active antiretroviral therapy (haart)
  1. B Achappa
  1. Department of Internal Medicine, KMC, Mangalore Affiliated to Manipal University

Abstract

Background HIV infection is the greatest risk factor for progression of latent Tuberculosis (TB) infection to active TB. Co-infection with these two pathogens is the greatest cause of death in HIV/AIDS patients. TB may develop or latent TB may become active following initiation of HAART. This study was done to evaluate risk factors contributing to development of active TB following initiation of HAART, to detect prevalence of latent TB in treatment naïve patients and to correlate latent TB at initiation of HAART to development of active TB during first year of treatment.

Methods This hospital based follow up study done over two years period (2013–14) included 48 treatment naïve patients initiated on HAART (2NRTI +1NNRTI). All subjects were screened at baseline for CD4 count, ESR, Quantiferon TB Gold test, BMI, past history of TB and followed up every three months for 1 year. Data collected was analysed using SPSS Version 11.5 statistical software.

Results 79% of patients were 31–50 years of age.30 were males and 18 females.

20.83% patients developed TB within 1 year of initiation of HAART. 23(47.9%) had latent TB (positive Quantiferon TB Gold test). Of these, 8 (30%) patients eventually developed TB, whereas 2 (8%) of patients with negative Quantiferon TB Gold test developed TB which was statistically significant.

7(70%) patients who developed active TB at end of study had CD4 T-cell count of less than 200/µl.13 out of 23 patients of latent TB and 6 out of 10 with active TB had BMI <18.5. 7 out of 18 latent TB patients who developed active TB had ESR above 40 mm/1stHr.

Conclusion Prevalence of latent TB is high in patients being initiated on HAART.

TB is more likely to develop in patients with lower BMI, higher ESR, lower CD4 count and Quantiferon TB Gold test positivity at baseline after initiation of HAART.

Disclosure of interest None.

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