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Prévalence de la co-infection VIH-tuberculose et impact de l’infection VIH sur l’évolution de la tuberculose pulmonaire au Togo

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

  • Santé Publique / Public Health
  • Published:
Bulletin de la Société de pathologie exotique

Résumé

L’étude a pour objectif de déterminer, d’une part, la prévalence du VIH chez les patients souffrant de tuberculose (TB) pulmonaire à microscopie positive et, d’autre part, d’évaluer l’impact du VIH sur le traitement de la TB. L’étude a concerné 569 patients tuberculeux pulmonaires chez qui l’infection VIH a été recherchée par tests rapides (Determine et Tridot). Le comptage du nombre de lymphocytes TCD4 (CD4) a été réalisé par Facscalibur (BD, Sciences) chez les patients séropositifs pour le VIH. Tous les patients avaient reçu le même traitement antituberculeux: deux mois de rifampicine-pyrazinamide-isoniazide-éthambutol, suivi de six mois d’isoniazide-éthambutol. Parmi les 569 patients, 135 (23,7 %) étaient infectés par le VIH. Le taux de guérison globale était de 82,2 %. Ce taux de guérison était de 64,3 % chez les séropositifs pour le VIH contre 87,5%chez les séronégatifs, avec une différence statistiquement significative (p < 0,01). Parmi les patients TB/VIH+, 55,8 % avaient un taux de CD4 inférieur à 200/μl. Le taux de guérison dans ce groupe était de 47,8 contre 84,4 % dans le groupe de patients séropositifs ayant un taux de CD4 supérieur à 200/μl. Il n’y avait pas de différence statistiquement significative entre les taux de guérison chez les patients TB/VIH− et les patients TB/VIH+ ayant un taux de CD4 supérieur à 200/μl. Compte tenu de l’impact négatif du VIH sur la TB, le Programme national de lutte contre la TB devrait prendre en compte la prise en charge simultanée de la co-infection TB/VIH pour améliorer sa performance.

Abstract

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 rifampicin-pyrazinamide-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.

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Authors and Affiliations

  1. Laboratoire national de référence des mycobactéries, Programme national de lutte contre la tuberculose, Lomé, Togo

    A. Y. Dagnra & S. Tchaptchet Heunda

  2. Service de pneumophtisiologie et des maladies infectieuses, CHU de Tokoin, Lomé, Togo

    K. Adjoh, A. A. Patassi & O. Tidjani

  3. Programme national lèpre-tuberculose, Lomé, Togo

    K. Adjoh, D. Sadzo Hetsu & F. Awokou

Authors
  1. A. Y. Dagnra
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  2. K. Adjoh
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  3. S. Tchaptchet Heunda
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  4. A. A. Patassi
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  5. D. Sadzo Hetsu
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  6. F. Awokou
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  7. O. Tidjani
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Correspondence to A. Y. Dagnra.

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Dagnra, A.Y., Adjoh, K., Tchaptchet Heunda, S. et al. Prévalence de la co-infection VIH-tuberculose et impact de l’infection VIH sur l’évolution de la tuberculose pulmonaire au Togo. Bull. Soc. Pathol. Exot. 104, 342–346 (2011). https://doi.org/10.1007/s13149-010-0079-3

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  • DOI: https://doi.org/10.1007/s13149-010-0079-3

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