Speaker Biography

Rajeev Shah

Professor & Head, Microbiology Department, PIMSR, Parul University, Vadodara. ,India

Title: A Retrospective Comparative Study of TB/HIV Co-infection in Relation to Mean CD4 Count in the Era of HAART

Rajeev Shah
Biography:

Professor & Head, Microbiology Department, PIMSR, Parul University, Vadodara. 

Abstract:

Individuals with HIV infection are at increased risk for tuberculosis (TB) and other respiratory tract infections. Infection with TB enhances replication of  HIV and may accelerate the progression of HIV  to AIDS, with rapid fall in CD4 count. CD4 count fall had been observed both in HIV positive as well as HIV negative patients of TB. Aim: Emphasizing the pivotal role of cART and ATT in TB/HIV patients in maintaining their immune system effective (by maintaining CD4 count) and thus decreasing MDR/XDR, morbidity and mortality among  these patients. Calculating average mean CD4 count  for  Indian scenario  in cART era. Material and methods: All the 961 HIV infected patients early morning sputa  were screened for AFB and few of the samples were even cultured on LJ medium.  All patients’ CD4 count were also evaluated by flow cytomerty method within one week of sputa collection. Seven other published work of HIV/TB patients were analyzed  in relation to CD4 count. Moreover other five published research  on  CD4 in TB+ve/HIV-ve  patients  were also discussed in this article. Results: Out of  961 patients with  HIV/RTI ,  308(32.06%) found positive for tuberculosis with  mean CD4 count  found to be 198.5 and 105.9 cells/μl  for pulmonary  TB  and for extra-pulmonary TB respectively in present study. The average mean CD4 count  from seven research studies from India  were found to be 169.75  and 145.3 cells/μl  for pulmonary and extra-pulmonary TB respectively, in TB/HIV co-infected patients on  cART.  Brenda et al.(1997)  and other four  found that  in advanced/sever  TB but HIV-negative  patients mean CD4 count found to be 341+116 .Conclusion: HAART  and ATT both are equally important in maintaining immune system(maintaining CD4 count)  of TB/HIV co-infected patients. In India, clinician should  more suspect  for TB at around   mean CD4 count of  169.75  even if found negative by AFB staining for, but should be confirmed  by culture on LJ medium, PCR or by any other Latest technique   in HIV-positive patients.

cART= combined Antiretroviral Treatment

ATT= anti Tubercle Treatment

Key Words:- Tuberculosis, HIV, CD4, ART