title: Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India.
abstract: OBJECTIVE
  There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. This study was done to assess the frequency and pattern of TB, outcome of anti-tuberculosis treatment, and the factors related to poor outcome of TB treatment in adult patients with HIV infection.
  
  
  METHODS
  Retrospective review of case records of HIV-TB co-infected patients attending the antiretroviral therapy (ART) clinic in a tertiary care centre in north India was done.
  
  
  RESULTS
  Of the 1754 patients included in the study, 583 (33.2%) were diagnosed with active TB and 466 (79.9%) of them had CD4 count less than 200/΅l at diagnosis. Extrapulmonary TB was diagnosed in 372 (63.8%) patients [76 (20.4%) had disseminated TB], and pulmonary TB in 211 (36.2%) patients. "Favourable outcome" (cure and completed treatment) was observed in 332 (77%) patients. Unfavourable outcome included default (8.1%), treatment failure (1.6%), and death (13.2%). At 1-year post-treatment follow up, 12 (3.6%) patients had disease relapse. CD4 count of less than 200/ ΅l at diagnosis [OR-2.32, CI (1.06-5.09)], and retreatment cases [OR-2.91, CI (1.22-6.89)] were independent predictors of unfavourable outcome.
  
  
  CONCLUSIONS
  There is an urgent need to strengthen the information, education, communication activities and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB. The findings highlight the need for performing drug susceptibility testing (DST) for patients starting retreatment regimen to improve treatment outcome.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Manish
authors.initials: M
authors.lastname: Soneja
authors.forename: K T
authors.initials: KT
authors.lastname: Prasad
authors.forename: Sanjay
authors.initials: S
authors.lastname: Ranjan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D000328:Adult; D006678:HIV / Q000472:pathogenicity; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007194:India; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology