Avaliação da dinâmica dos linfócitos T CD 4+ em pacientes adultos com coinfecção TB-HIV aderentes e não aderentes ao TARV, internados no Hospital Geral da Machava, de Janeiro a Novembro de 2022

Abstract

Acquired Immunodeficiency Syndrome (AIDS) is an infectious disease caused by the human immunodeficiency virus (HIV) and is characterised by intense immunosuppression. It is estimated that there are around 39.4 million people infected with HIV associated with tuberculosis (TB-HIV co-infection) worldwide, with a higher proportion in middle and low-income countries, including Mozambique. The country has high rates of TB-HIV co-infection, where it is estimated that around 13.2 per cent of the population is co-infected. The aim of this study was to assess the dynamics of TCD 4+ lymphocytes in adult TB-HIV co-infected patients who were adherent and non-adherent to antiretroviral treatment. The study was cross-sectional and retrospective, in which data were collected from registry books and patient files on the clinical development and demographics of patients admitted to the four wards of Machava General Hospital from January to November 2022, in which adherence to antiretroviral treatment and CD4+ T-lymphocyte levels were the main variables under study.A total of 384 patients were included in the study, of whom 199 (51.8%) were male and 185 (48.2%) female. The study found a high frequency of co-infection in males, with a higher frequency of pulmonary tuberculosis and a low CD 4+ T-lymphocyte count 209 (54.4%) with mainly WHO stage III 284/384 (73.9%). The clinical and sociodemographic variables associated with the development of co-infection were WHO stage (p-value 0.006), adherence to ART (p-value <0.001) and the number of pathologies in the 18-25 and 26-33 age groups (p-values 0.01 and 0.008). Evaluation of the dynamics of CD 4+ T lymphocytes in adult patients with co-infection, adherent and non-adherent to ART, admitted to Machava General Hospital, from January to November 2022, showed a higher frequency of co-infection cases in male patients adherent to ART, in the 34-41 age group, with pulmonary tuberculosis being the most frequent in both groups. tuberculosis being the most frequent in both groups, especially at advanced infection levels (WHO III), with anaemia and respiratory failure being the most frequent pathologies among adherents and malnutrition being a common risk factor for co-infection. Most of the patients admitted to the HGM had low CD 4+ T-lymphocyte levels, mainly males who were adherent to ART, and only a quarter of the patients had high CD 4+ T-lymphocyte levels, most of whom were females who were also adherent to ART and number of pathologies were significantly associated with CD4+ T lymphocyte levels. (TRADUÇAO NOSSA)