EFFECTIVENESS OF ISONIAZID PREVENTIVE THERAPY ON INCIDENCE OF TUBERCULOSIS AMONG PEOPLE LIVING WITH HIV IN SOUTHERN MAHARASHTRA

Abstract

Tuberculosis being the foremost opportunistic infection associated with Human Immunodeciency Virus infection contributes to high morbidity and mortality among HIV seropositive persons. As per World Health Organisation TB statistics for 2020, and the India TB Report 2021- The incidence of TB cases including HIV in India was 193 per 100000 population, of which mortality was 32 per 100000 cases. Isoniazid Preventive Therapy reduces the reactivation of latent Tuberculosis infection and reduces the risk of acquiring TB by 70-90% among HIV co-infected individuals. WHO recommends use of ART and Isoniazid Preventive Therapy (IPT) combination to reduce the burden of TB among HIV infected patients. Considering the benets of IPT in PLHIV patients, this study was conducted over a period of 2 years from January 2020 to December 2021 in patients attending ART OPD of a tertiary care hospital in southern Maharashtra. Methods A prospective observational study was conducted on patients attending ART OPD along with General Medicine OPD at a tertiary care hospital from January 2020 to December 2021. A total of 1497 PLHIV patients were started on IPT during this period and followed up. Results 92.18% i.e. 1380 of 1497 patients completed 6 months of IPT with remaining 7.82% i.e. 117 patients not able to complete the entire 6 months due to treatment related side effects, follow up difculties or mortality. Of 1497 patients, only 2 patients (0.13%) developed Pulmonary Tuberculosis after initiation of IPT and the remaining didn't show any signs or symptoms of tuberculosis on follow up. Conclusion Results of IPT in PLHIV were highly effective with only 0.13% i.e. 2 patients developing Tuberculosis during the course of treatment with the remaining not having tuberculosis even on follow up or being reported till date. The results of the study along with other studies conducted worldwide clearly indicate the effectiveness of IPT in PLHIV and thereby its implementation should be further strengthened.