Incidence of Tuberculosis in Latent TB Infected (LTBI) Patients Living with HIV under Antiretroviral Therapy in the Lomé Infectious Disease Department

Abstract

Objective : To determine the incidence of tuberculosis in person living with HIV infected by latent TB and under antiretroviral (ARV) therapy. Method : We studied prospectively for 36 months the occurrence of bacilliform pulmonary tuberculosis in patients infected with HIV, naive of BCG and receiving antiretroviral treatment. Each patient had an intradermal reaction (IDR) of 10 IU tuberculin Mérieux. The measurement of the nodule is made 72 hours later. During follow-up, patients were reviewed every six months for active tuberculosis. Results : A total of 212 out of 257 patients had an IDR greater than 5 mm, an ITL prevalence of 86.33%. Three patients were lost to follow-up during the study. The predominant female sex is 69.81%. The mean age was 42.8 ± 10.02 years. A previous history of tuberculosis was found in 14.15% of patients and 208 patients (98.11%) had HIV1. In 39.15% of patients, patients had a CD4 count lower than 350 cells/mm3 at baseline in the study. At the end of the three-year follow-up, among the 14 patients, 11 had failed ARV therapy and had developed TB, with an incidence of 2.20 cases per 100 patients. Conclusion : The incidence of active tuberculosis in LTBI was very high in HIV-positive patients with low CD4 count, hence the importance of reliable LTBI screening such as gamma interferon is better than patient follow-up.