Trends of tuberculosis in cohorts of positives HIV patients before and after the HAART era in health institutions of Medellin (1996-2005)

Abstract

Tuberculosis (TB) is still an important disease with public health impact. Which has increased since HIV epidemic emergence. The preventive role of highly effective antiretroviral (HAART) against TBdisease is not enough to control TB because it requires regular administration and adherence to therapy. Since HAART implementation around the world, de TB, co morbidity has decreased, but is no the only factor to control it. Objectives: to determine TB trend in HIV infected patients, during HAART implementation in two patient cohorts coming from different health centers of Medellín. Methods: a descriptive study was conducted based on registries and data bases from a referral program to care HIV/AIDS patiens in different health centers in the city during 1996 to 2002, and a retrospective cohort of HIV patients with data from clinical registries which was comprised in order to compare TB risk in a prophylaxis study during 2003-2005. Results: we report an increasing trend of HAART therapy use during the period of study, with 60% of HIV patients with irregular therapy during the last period (2003-2005). The annual TB incidence was between 0.1 to 5.1%. The TB proportion among the HIV patients who did not received haart effectiviness was 60% (RR=0.4). Conclusion: HAART therapy must be administered at each HIV/AIDSpatients when the risk of developing TB is high, according to this results, HAART therapy is effective but is not the only factor to control TB in this population