The effect of tuberculosis and antiretroviral treatment on CD4+ cell count response in HIV-positive tuberculosis patients in Mozambique

BMC Public Health

Research Article

Frank van Leth¹  Miranda Brouwer²  Paula Perdigão³  Paula Samu Gudo⁴  Chalice Mage Simbe⁵ 

[1] Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Pietersbergweg 17, 1105, Amsterdam, BM, The Netherlands;KNCV Tuberculosis Foundation, Postbus 146, 2501, The Hague, CC, The Netherlands;Health Alliance International, Technical Assistance Unit, Maputo, Mozambique;Independent chest physician, Maputo, Mozambique;Ministry of Health, National TB Programme, C.P. 264 Av. Eduardo Mondlane/Salvador Allende, Maputo, Mozambique;Ministry of Health, Provincial Health Directorate Manica Province, Chimoio, C.P. 264 Av. Eduardo Mondlane/Salvador Allende, Maputo, Mozambique;

关键词: Human Immunodeficiency Virus;    Human Immunodeficiency Virus Test;    Human Immunodeficiency Virus Patient;    Human Immunodeficiency Virus Prevalence;    Human Immunodeficiency Virus Treatment;   

DOI  :  10.1186/1471-2458-12-670

 received in 2011-12-21, accepted in 2012-06-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTuberculosis (TB) presents a serious problem in Mozambique. HIV prevalence among TB patients is estimated at 47%. A delay in having their first CD4+ cell count could lead to a missed opportunity for ART initiation due to a CD4+ cell increase above the cut-off caused by TB treatment. The objective is to describe CD4+ cell response during TB treatment and quantify the effect of TB treatment and ART on this response.MethodsAll new HIV + adult TB cases in 2007 from three TB clinics in Mozambique were included. Data on TB diagnosis and treatment and HIV parameters were collected. A general mixed model was used for CD4+ cell count response.Results338 HIV + patients were notified and 252 (75%) were included in the analysis. Using TB medication was not independently associated with the CD4+ count response (19 cells/mm3; 95% CI: -40 to 79; p = 0.529). ART-use was associated with statistically significantly higher CD4+ cells compared to no ART-use (81 cells/mm3; 95% confidence interval (CI): 12 to 151; p = 0.022).ConclusionIn this study, no independent effect of TB treatment on CD4+ cell count was found. HIV-infected TB patients on ART had a significantly higher CD4+ cell count than those not receiving ART. CD4+ cell counts for patients not on ART at TB treatment start, remained below the cut off for initiating ART during the first three months of TB treatment; therefore some delay in getting the first CD4+ cell count would not lead to missing the opportunity to start ART.

【 授权许可】

CC BY   
© Brouwer et al.; licensee BioMed Central Ltd. 2012