HIV Patients Under Antiretrovital Therapy At High Risk of Active Tuberculosis

A new study revealed that HIV patients who had undergone highly active antiretroviral therapy (HAART) had increased risk of developing active tuberculosis (TB) up to five times higher.

HAART therapy, as described by the National Institute on Drug Abuse, is a modified combination of different classes of medications that doctors prescribe based on the number of virus present in a patient’s blood, the type of virus, the CD4 cell count, and other considerations.

Kogieleum Naidoo, lead author of the study from the Centre for the AIDS Programme of Research in South Africa (CAPRISA), and his colleagues studied a large population of HIV patients living in the countryside of the KwaZulu-Natal province of South Africa.

About 17 percent of the population, or 173, were diagnosed of active tuberculosis before the therapy began. After three months, the researchers discovered that the incidence rate increased three times wherein over 50 percent of the patients were affected. It then declined during the fourth month up to 24 months of monitoring. The severity of the HIV infection doesn’t factor in the development of the complication based on the comparison made between patients with CD4 cell counts below 50 cells/mm³ and those with 200 cells/mm³.

CD4 or the T-cells are the cells which protect our immune system against bacteria and viruses. A normal CD4 count of a person is between 500 cells/mm³ and 1,000 cells/mm³. The U.S. Department of Health and Human Services suggest initiating treatment when your CD4 count drops to 350 cells/mm3 or below which indicates that the person may be on the early stage of HIV infection.

The researchers also discovered that the TB rates vary by gender and age wherein females are twice higher at risk than males and those with age between 24 and 34 are five times higher at risk than 35 years old and above.

The development of TB on HIV patients is bad news for the patients because the researchers also found out that there was a rebound of CD4 counts a year after their HAART treatment.

The results of the study were presented at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention.

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