Dual burden of tuberculosis and human immunodeficiency virus: Outcomes and implications from Chittoor district, Andhra Pradesh

Abstract Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection remain a significant public health challenge, particularly in resource-limited settings. This study investigates the prevalence, clinical characteristics, and treatment outcome of TB-HIV coinfected patients in Chittoor, Andhra Pradesh, India. Methodology: A retrospective cross-sectional observational study was conducted using hospital records in an antiretroviral therapy (ART) Centre of a tertiary care hospital from October 2021 to September 2023. Among 3383 registered HIV patients, 129 (3.8%) were diagnosed with TB. Clinical data, diagnostic methods, and treatment outcomes were analyzed. Results: Most patients were males (62.0%), with a mean age of 39.7 years. Pulmonary TB was the most common type (93.0%), and 58.1% of cases were microbiologically confirmed. The median baseline and follow-up CD4 counts were 309 and 430 cells/mm 3 , respectively. TB treatment adherence was 74.6%, while 24.0% defaulted, contributing to 84.4% of the reported deaths. Incomplete isoniazid preventive therapy was a significant predictor of treatment default and mortality. Conclusion: Despite progress in ART coverage and TB diagnosis, challenges in treatment adherence and mortality reduction persist. Strengthening diagnostic infrastructure, adherence strategies, and integrated TB-HIV care is crucial to improve outcomes in co-infected populations.