Introduction: The burden of disease due to HIV/AIDS and tuberculosis
remains great for many countries around the world. Continuing attention must
be devoted to these epidemics if we ever hope to one day contain their
devastating effects on humankind. The objective of this study is to; to evaluate
and compare cohort treatment outcomes of HIV infected TB patients and HIV
infected non-TB patients treated with HAART at the Themba Lethu Clinic
between 1st April 2004 and 1st April 2007. To measure outcomes in CD4, viral
load, hemoglobin, liver function tests, weight, BMI, loss to follow up and
death and to compare this outcomes between HIV patients who have had TB
and HIV patients who have never had TB.
Materials and Methods: information collected of patients for three years
shall be used to carry out analysis. A total of 5818 patients were included in
the cohort sample. 19.23% (1,048) of the patients had been diagnosed with
TB at some point in time while 80.77% (4,770) had never been diagnosed with
TB. Mean baseline CD4 cell counts were 113.47cells/mm3 for non TB patients
and 88.85cells/mm3 for those who have ever had TB. This baseline CD4
counts are considered 2 months prior to ARV start and 1 month post the start
of ARV. Baseline means for weight, BMI, AST and ALT were also taken into
consideration by the two patient groups. Clinical out come was assessed and
evaluated by comparing incidence of designated end points either as survival
or failures. Incidence of deaths and loss to follow up was also compared in the
two groups of patients.
Results: Among HIV non TB patients, incidence rate of them having CD4
counts greater than 200 was at 36.47 persons per 10000 person days while for
the patients who had been diagnosed with TB incidence of CD4 rising to above
x
200 was lower at 34.19persons per 10000 person days. A rate ratio of 0.94
(95% CI 0.85 - 1.03) showed no true difference in the two groups. When
looking at deaths in the two groups of patients, incidence in those who had TB
was 3.84 deaths per 100 patient years and 4.16 deaths per 100 patient years for
the non TB group with RR 0.93 and CI 0.66 - 1.28. Differences in incidence
and outcomes were noticed in Hb gain, weight and BMI change, Liver
function test changes over time and loss to follow up “defaulters”. Survival
curves were modeled to show trend of change and log rank test were used to
ascertain equality of survival curves. Where log rank p. values < 0.05 were
noticed among survival curves of weight, BMI, AST, ALT, Hb and Loss to
follow up. This again showed differences in weight, BMI, hemoglobin, AST,
ALT and loss to follow up while no statistical differences were recognized
between the two groups of patients when considering changes in CD4, deaths
and Viral load over time as log rank test failed to reject the null hypothesis of
similar curves.
Conclusion: Data indicated that similarity and differences between HIV TB
patients and HIV non TB patients could vary along certain outcomes. But one
sure point is both groups of patients had an equal chance of staying alive when
properly treated with ARV/HAART.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/6964 |
| Date | 21 May 2009 |
| Creators | Akiy, Zeh Zacheaus |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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