Revista de SIDA e investigación clínica

Background: Human immunodeficiency virus and tuberculosis are the leading independent global causes of death among patients with infectious diseases. Additionally, due to the shared immune defense mechanisms, they are the leading cause of co-morbidities globally. However, little information was found regarding the proportion of TB/HIV co-infection in the study area. Thus, this study assesses the proportion and associated factors of TB/HIV co-infection.

Objective: To assess the prevalence of Tuberculosis and Human Immune Deficiency Virus Co- Infection and Associated Factors among patients attended TB clinic in five years (May 2015-April 2020) at Debre Tabor Comprehensive Specialized Hospital, North central Ethiopia, 2020.

Methods: The Institutional based quantitative Retrospective cross sectional study was conducted among the records of 298 Tuberculosis patients registered for treatment in TB-HIV co-infection at Debre Tabor Comprehensive Specialized Hospital, North central Ethiopia, DOT’s clinic from May 2015 to April 2020. Simple random sampling technique will be used to select Record data. Pre-tested Check list was used to collect data. Data was entered in Epi info version 7, and was analyzed using statistical package for social sciences version 20 software. Bivariate and multivariable logistic regeration model was fitted to identify factors associated Tuberculosis Treatment Outcome. Odds ratio with 95% confidence interval was computed to determine the level of significance. P-value less than or equal to 0.05 considered as significance.

Results: In this Study, the overall prevalence of HIV among TB patient was 53 (17.8 %). In multivariable analysis Urban Residence [AOR (95 % CI)= 2.061(.942,4.510), Age category 18-30years [AOR (95 % CI)= 0.458(0.227,0.925)], and PTB SNPTB category (Types), ((AOR=2.896 [(95% CI:1.069,7.850]), PTB Smear Unknown (AOR= 12.225 [95% CI: 1.896,19.903], EPTB (AOR=11.225 [95% CI:1.138,17.695]) were remained significantly associated with the outcome variable with at 95% CI and P- value of <0.05.

Conclusion: Generally this study shows relatively higher TB-HIV co-infection than a number of other studies held in different part of the country even though there was decreasing rate of TB-HIV co- infection in the study area from 44% to 17.8% in the last 4year. The TB-HIV co-infection was significantly associated with type of TB, age; residence and weight requires attention to reduce TB- HIV co-infection.

Background: Both normal aging and HIV infection impact B cell functionality and lead to activation of resting B cells, memory cell depletion and altered gene expression. As a result, HIV+ individuals and the elderly fail to demonstrate robust and durable immune responses against pneumococcal polysaccharides. Herein, we assessed altered B cell function in high risk groups by utilizing single cell technology.

Methods: HIV-positive individuals with CD4+T cell counts >200 on Antiretroviral Therapy (ART) and HIV-negative individuals age groups 21-40 and 50-65 received pneumococcal vaccination. Serum IgG and IgM PPS-specific antibodies were measured pre- and post-immunization using ELISA method. Evaluation of B cells was performed using flow cytometry and single cell RT-PCR.

Results: IgM memory B cells are important players in responding to pneumococcal antigens and are present in reduced quantities in HIV+ and aging HIV- individuals. Single cell analysis of IgM memory B cells demonstrated heterogeneity and identified two unique subpopulations. One of the subpopulations represents B cells with higher expression of TACI and BAFF-R and is more likely to dominate in T-cell independent immune responses. IgD+IgM+memory B cells were present in equal proportions in both subpopulations.

Conclusion: Pneumococcal vaccine responses in HIV+ and aging HIV- individuals are multifactorial and largely depend on the abundance and phenotypic characteristics of IgM memory B cells.