title: TB treatment outcomes among TB-HIV co-infections in Karnataka, India: how do these compare with non-HIV tuberculosis outcomes in the province?
abstract: BACKGROUND
  India accounts for 23% of the global incidence of TB cases; it also has an estimated 2.3 million HIV infections. Of the 2 million TB incident cases, 5% occurred in HIV infected persons. The country has large national TB and HIV control programs. This paper describes characteristics of TB-HIV co-infection cases registered under the program in Karnataka province, India. Treatment outcomes for coinfected patients are compared with those for TB patients in the province.
  
  
  METHODS
  Program reports from the National AIDS Control program and the National TB control program for Karnataka province (a high HIV prevalence state, population 61 million) were analysed. Data from patients registered in each program in 2010-2011 was studied.
  
  
  RESULTS
  Of the 6,480 adult co-infections, a third occurred in women; 78% of patients were initiated on ART. Among the cohort 73% had pulmonary TB, and 46% reported sputum positivity for acid fast bacilli. Treatment success among co-infected patients not on ART (54%) were significantly lower compared to those already on ART (80%); death and default rates were higher in the non-ART group. Treatment success proportions (75%) for the co-infected patients were similar to those for the 51,966 patients registered under the TB program. Death rates among co-infected patients (15%) were twice as high as for TB patients under the program, though default and failure rates were lower.
  
  
  CONCLUSIONS
  Co-infected patients already on ART demonstrated better TB outcomes in than those not on ART. Compared to those with TB only, co-infected patients had similar TB treatment success rates and lower rates of treatment default and failure. Integration of TB-HIV collaborative activities will strengthen our battle to control TB and HIV globally.
authors.affiliation: Karnataka State AIDS Prevention Society, Bangalore, Karnataka, India. susha007@gmail.com.
authors.forename: Suresh
authors.initials: S
authors.lastname: Shastri
authors.forename: Balaji
authors.initials: B
authors.lastname: Naik
authors.forename: Anita
authors.initials: A
authors.lastname: Shet
authors.forename: Bharat
authors.initials: B
authors.lastname: Rewari
authors.forename: Ayesha
authors.initials: A
authors.lastname: De Costa
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003140:Communicable Disease Control; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012424:Rural Population; D015996:Survival Rate; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D000998:Antiviral Agents
references.citation: Int J Tuberc Lung Dis. 2000 Sep;4(9):839-44
references.pmid: 10985652
references.citation: Am J Respir Cell Mol Biol. 2011 Dec;45(6):1116-24
references.pmid: 21852682
references.citation: J Infect Dis. 2003 Oct 15;188(8):1146-55
references.pmid: 14551885
references.citation: J Acquir Immune Defic Syndr. 2006 Sep;43(1):42-6
references.pmid: 16885778
references.citation: N Engl J Med. 2010 Feb 25;362(8):697-706
references.pmid: 20181971
references.citation: Trop Med Int Health. 2011 Nov;16(11):1380-3
references.pmid: 21831116
references.citation: JAMA. 2008 Jul 23;300(4):423-30
references.pmid: 18647985
references.citation: Int J Tuberc Lung Dis. 2010 Feb;14(2):247-9
references.pmid: 20074420
references.citation: Am J Respir Crit Care Med. 1997 Mar;155(3):996-1003
references.pmid: 9117038
references.citation: PLoS One. 2011;6(9):e24297
references.pmid: 21931674
references.citation: N Engl J Med. 2011 Oct 20;365(16):1471-81
references.pmid: 22010913
references.citation: Clin Infect Dis. 2010 May 15;50(10):1377-86
references.pmid: 20388036
references.citation: N Engl J Med. 1993 Oct 7;329(15):1122-3
references.pmid: 8371737
references.citation: JAMA. 1992 Sep 23-30;268(12):1581-7
references.pmid: 1518113
references.citation: J Biosci. 2008 Nov;33(4):527-37
references.pmid: 19208978
references.citation: Int J Infect Dis. 2009 Nov;13(6):722-9
references.pmid: 19196530
references.citation: Cad Saude Publica. 2008 Apr;24(4):887-96
references.pmid: 18392367