Prevalence of HIV-TB co-infection and impact of HIV infection on pulmonary tuberculosis outcome in Togo

The aim of this study was to determine the prevalence of HIV infection in tuberculosis patients and its impact on the TB treatment. We enrolled 569 pulmonary TB patients in four diagnosis and treatment centres in Togo. All patients were new TB cases and received the first-line TB drugs: two months of rifampicinpyrazinamide-isoniazid-ethambutol and six months of isoniazid-ethambutol. HIV testing was done according to the national guidelines, using rapid diagnosis tests. The CD4 lymphocyte counting was performed by Facscalibur (BD, Sciences) for all HIV-positive patients. Of the 569 TB patients enrolled, 135 (23.7%) were HIV positive (TB/HIV+). HIV prevalence was 22.4% (76 of 339) among men and 25.6% (59 of 230) among women without statistical difference. The global rate of treatment success was 82.2%. The rate of treatment success was lower (64.3%) in TB/HIV+ patients than in TB/HIV- patients (87.5%) (p <0.01). The mortality rates were 25.6% and 11.8% in TB/HIV+ patients and TB/HIV- patients, respectively, with a statistically significant difference (p <0.01). We did not found any statistical difference between the rates of treatment success among TB/HIV- (87.5%) patients and TB/HIV+ patients who had TCD4 lymphocyte counts above 200/μl (84.4%). TB program in Togo must take into account HIV infection to improve its performance. © Société de pathologie exotique et Springer-Verlag France 2010.