Human Immunodeficiency Virus (HIV) infection continues to be a major global health problem; a 2011 estimate indicates that 23.5 million people living with HIV resided in sub-Saharan Africa, which represents 69% of the global HIV burden [1]. Also in 2011, 8.7 million people became ill with tuberculosis (TB) of which 1.4 million died [2]. There were about 1.1 million new cases of HIV-positive new TB cases with 79% of them living in Africa and globally about 430,000 people died of HIV-associated TB [2].
Advanced immune suppression remains the most important risk factor for tuberculosis in those with HIV [3], but epidemiological and clinical factors have also been identified [4,5]. We previously evaluated risk factors for TB in our population of adult patients on antiretroviral therapy (ART) and noted that poor immunologic and/or virologic response to ART and male sex were some of the risk factors for TB in ART patients [6]. However, we do not know if such risk factors differ in pre-ART patients.
Pulmonary tuberculosis (PTB) is predominantly responsible for TB transmission in human populations [7,8]. Prevalence and known risk factors for PTB among HIV-infected adults vary from one setting to another [5,9,10]. Identification of the factors associated with PTBHIV co-infection in pre-ART HIV patients could have implications for clinical management and TB control strategies.
In this study, we determined the factors associated with PTB coinfection in a cohort of ART-naive HIV-infected patients presenting to the AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic at the Jos University Teaching Hospital (JUTH), Jos.