Results of rapid and successful integration of HIV diagnosis and care into tuberculosis services in Benin
OBJECTIVE: To describe the characteristics and TB treatment outcomes of the first cohorts of TB-HIV patients, and to assess programmatic outcomes.
METHODS: Retrospective cohort study using data from the TB register and the register of co-infected patients.
RESULTS: During the study period, 8368 TB patients were registered, 7787 (93%) were tested for HIV and 1255 (16%) were HIV-positive, including 385 (32%) who already knew their positive status. Most patients (88%) were tested within 15 days of TB diagnosis. Female and young patients were overrepresented among the co-infected. Cotrimoxazole preventive therapy was administered to 1152 patients (95%) during anti-tuberculosis treatment, and antiretroviral treatment (ART) to 469 (42%). The likelihood of receiving ART increased as initial CD4 lymphocyte counts decreased. Fifteen per cent of TB-HIV patients died during anti-tuberculosis treatment. Patients already on ART prior to anti-tuberculosis treatment experienced the worst outcomes. Patients who initiated ART early during anti-tuberculosis treatment or in the timeframe recommended by the guidelines fared the best.
CONCLUSION: HIV care has been successfully and sustainably integrated into TB services in Benin. However, ensuring the access of co-infected patients to more favourable treatment outcomes still represents significant challenges.
Keywords: ART initiation; TB-HIV collaboration; integrated TB-HIV care; provider-initiated testing and counseling
Document Type: Research Article
Affiliations: 1: International Union Against Tuberculosis and Lung Disease, Paris, France 2: Programme National de Lutte contre la Tuberculose, Cotonou, Benin
Publication date: 01 November 2013
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