title: Incidence of tuberculosis and immunological profile of TB/HIV co-infected patients in Nigeria.
abstract: BACKGROUND
  We obtained estimates of the incidence of tuberculosis (TB) among patients receiving HIV Treatment. We also modeled the relationship between incident TB and change in CD4 count over the follow-up period.
  
  
  METHODS
  We analyzed the incidence of TB over 10 years from initiation of HIV treatment among 345 HIV treatment-naïve persons, who were enrolled in a cohort in Kano, Nigeria. We used Generalized Estimating Equation [GEE] to identify determinants of TB incidence and model the relationship between the occurrences of TB with change in CD4 count over the follow-up period. We created Kaplan-Meier curves stratified by anti-retroviral therapy (ART) treatment failure status to examine the effect of first line ART treatment failure on occurrence of TB.
  
  
  RESULTS
  During the 10-year period, 47(13.62%) had TB [incidence was 7.43 per (1,000) person year)]. It is associated with decreasing age (OR = 0.98), female gender (OR = 0.83), being on first line ART other than AZT (OR = 0.87), poor adherence (OR = 1.25), change in ART regimen (OR = 2.3) and ART treatment failure (OR = 1.51). Odds of TB occurrence was also associated with CD4 increment at 10 years (OR = 0.99). Those with TB/HIV co-infection tend to have statistically significant shorter time to failing first line ART regimen compared to those with HIV infection alone.
  
  
  CONCLUSIONS
  There was high incidence of TB in the studied HIV cohort with a deleterious effect on the outcome of ART treatment. There is need for early TB screening and re-screening among all HIV patients.
authors.affiliation: Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Baba Maiyaki
authors.initials: BM
authors.lastname: Musa
authors.affiliation: Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Babashani
authors.initials: B
authors.lastname: Musa
authors.affiliation: Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Hamza
authors.initials: H
authors.lastname: Muhammed
authors.affiliation: Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Nashabaru
authors.initials: N
authors.lastname: Ibrahim
authors.affiliation: Section of Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Abubakar Garbati
authors.initials: AG
authors.lastname: Musa
keywords: HIV; Nigeria; incidence; tuberculosis