Abstract

This biphasic study investigated the prevalence and co-infection of the human immunodeficiency virus (HIV) and tuberculosis (TB) along major transport routes of Enugu State; their consortium in active HIV disease and the role of cluster differentiation 4 (CD4) cells and other haematologic parameters as markers of HIV progression. Prevalence and co-infection with HIV and TB were studied in the preliminary phase (Phase 1: 1999 to 2001), among 12,000 individuals who were screened for HIV using determine rapid test kits and TB by the Ziehl-Neelsen staining technique. Effect of TB on HIV progression using CD4 cell (estimated by cytometry using Partec Cyflow SL-3 counter) as surrogate marker was studied in Phase 2 (2005 to 2008) among 50 of those subjects presenting with AIDS-related clinical symptoms. Other investigated parameters included white blood cells (WBC) and haemoglobin/packed cell volume (PCV). The rate of co-infection with HIV and TB was 49.6%. The effect of TB on the progression of HIV to acquired immune deficiency syndrome (AIDS) was highly significant at α = 0.05. The study confirmed the role of TB in furthering the progression of HIV to AIDS as well as the importance of the surrogate markers as indicators of immune system deterioration and subsequent decline.

Key words: Prevalence, co-infection, cluster differentiation 4 (CD4) cells, tuberculosis (TB), human immunodeficiency virus (HIV), surrogate markers.