Among Kenyans with prior tuberculosis, one third had lab-confirmed HIV infection, according to results of a nationally representative survey. Adult HIV prevalence stood at 5.6%.
TB remains a leading cause of morbidity and mortality among HIV-positive people across sub-Saharan African. To define intersections between the two diseases, researchers analyzed data from the second Kenya AIDS Indicator Survey, a national population-based household survey conducted from October 2012 to February 2013. Researchers collected blood samples for HIV testing and measurements of CD4 count and viral load.
The survey involved 13,720 people from 15 to 64 years old, 5.6% of whom tested positive for HIV. Among all survey respondents, 96.7% had ever heard of TB, and 2.0% of that group (95% confidence interval [CI] 1.7 to 2.2) had prior TB. Among people with lab-confirmed HIV infection, 11.6% (95% CI 8.9 to 14.3) had prior TB.
Among people with prior TB, 33.2% (95% CI 26.2 to 40.2) had lab-confirmed HIV infection. In contrast, 5.1% (95% CI 4.5 to 5.8) without prior TB had lab-confirmed HIV infection.
Among people receiving medical care and with prior TB, 100% of those eligible for antiretroviral therapy (ART) were receiving ART, compared with 88.6% of those without prior TB (95% CI 81.6 to 95.7). Among all HIV-positive people surveyed, 86.9% (95% CI 74.2 to 99.5) eligible for ART and with prior TB were receiving ART, compared with 58.3% (95% CI 47.6 to 69.0) of those without prior TB.
“Without universal knowledge of HIV serostatus in this country with a generalized HIV epidemic,” the researchers note, “the full benefit of ART for prevention of HIV transmission as well as of morbidity and death, including from tuberculosis, will not be realized.” They see a need for “much greater emphasis on preventing tuberculosis among persons living with HIV.”
Source: Agneta Mbithi, Anthony Gichangi, Andrea A. Kim, Abraham Katana, Herman Weyenga, John Williamson, Katherine Robinson, Tom Oluoch, William K. Maina, Timothy A. Kellogg, Kevin M. De Cock. Tuberculosis and HIV at the national level in Kenya: results from the second Kenya AIDS Indicator Survey. JAIDS. 2014; 66 Suppl 1: S106-S115.
Source: IAS