Background: Co-infection of HIV and TB pose a major burden on health system. This study aimed to improve the survival of TB/HIV co infected patients in Pakistan by estimating the incidence and identify the associated risk factors of TB/HIV co infection.
Methodology: A retrospective cohort study conducted at Anti Retroviral Treatment Center, Islamabad. A total of 2542 People Living with HIV medical records (enrolled from January 2006 to December 2016) information reviewed and extracted for study purpose. Analysis was done for calculating incidence, frequency distribution and association for determinants.
Results: We followed 2386 study participants in the follow up for 4433 years in total. Mean observation period was 1.86 ± 1.93 years. Cumulative incidence and incidence rate of TB among HIV/AIDS patients was 446 (18.7%) and 0.001 cases/10,000 Person Years respectively. About 362 (81%) of incident TB occurred within the one year of follow up. Majority 327 (73.3%) of the cases were pulmonary TB. Out of 446 TB infected persons, 440 (98.6%) received medication for TB. INH prophylaxis was prescribed to few 17 (0.7%) of the respondents. Significant association of TB was found with history of work in abroad, patient age, years since developing disease and current HIV stage at p-value <0.05. Binary logistic regression predicted that anemic group was 3.1 times more likely of having TB infection than non-anemic group. Being infected with HIV/AIDS was a risk factor of TB regardless of the CD4 count and WHO HIV stage.
Conclusion: This study found high incidence of TB co-infection in HIV patients. Joint effort of National AIDS Control Program and National TB Control Program is a matter of great urgency at basic health levels to control the co-infections.
Key words: HIV/AIDS, TB, Incidence, Risk factors, Co-infection, Lower-middle income country