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Title
Assessing the additional benefit of Tuberculosis Preventive Therapy among people living with HIV/AIDS on Dolutegravir-based antiretroviral therapy in two North Central states in Nigeria
Presenter
Charles Eyefian
Authors
C. Eyefian1, M. Dimas1, O. Fasanya2, Y. Sambo1, U. Atoi1, V. Anozie3, E. Oguns4, E. Ezieke5, J. Gotom5, T. Jasper5, V. Adejo5, O. Adebayo5, C. Mensah6, P. Dakum6, H. Omuh5
Institutions
1Institute of Human Virology Nigeria, Nasarawa State Office, Prevention Care and Treatment, Lafia, Nigeria, 2Institute of Human Virology Nigeria, Nasarawa State Office, Strategic Information, Lafia, Nigeria, 3Institute of Human Virology Nigeria, FCT Office, Prevention Care and Treatment, Abuja, Nigeria, 4Institute of Human Virology Nigeria, FCT Office, Strategic Information, Abuja, Nigeria, 5Institute of Human Virology Nigeria, Central Office, Prevention Care and Treatment, Abuja, Nigeria, 6Institute of Human Virology Nigeria, Office of the CEO, Abuja, Nigeria

BACKGROUND: Tuberculosis (TB) is the leading cause of morbidity and mortality among People Living with HIV/AIDS (PLHIVs), accounting for 214,000 deaths globally in 2020. Tuberculosis Preventive Treatment (TPT) has been associated with a decrease in TB disease among PLHIV, while Dolutegravir (an integrase strand inhibitor) is associated with improved viral suppression and a decrease in co-morbidities. This study aims to investigate if TPT confers additional protection against TB susceptibility in PLHIV who have been on a Dolutegravir-based regimen (DBR) for at least 6 months.
METHODS: A retrospective cross-sectional comparative analysis of data was carried out between two tertiary treatment facilities: one in Nasarawa State (Dalhatu Araf Specialist Hospital - facility A) and the other in the Federal Capital Territory (National Hospital Abuja - facility B). A total of 2460 PLHIV from facility B were on DBR only without TPT, while facility A (the control) had 4688 PLHIV on DBR and TPT (isoniazid was used). All clients in this study from both facilities had been on a DBR for at least 6 months and did not have active TB at the beginning of the review period. Data was analyzed using Excel in the Microsoft 365 Office application to see if TPT had any additional benefit in terms of TB susceptibility for PLHIVs on a DBR. Data for FY 22 (October 2021–September 2022) was used.
RESULTS: During the review period, 5 (0.2%) of the 2460 PLHIV in facility B developed active TB, 2443 (99.3%) clients were eligible for VL and had viral load results, and 2387 (97.1%) were virally suppressed. All the clients with concomitant TB disease were virally suppressed (VL <1000 cc/mL). Of the 4688 PLHIV in facility A, 14 (0.29%) developed active TB, 4668 had viral load results, and 95.4% (4453 clients) were virally suppressed, while 78.6% (11 of 14) of the clients with concomitant TB disease were virally unsuppressed (VL >1000 cc/ml).
CONCLUSIONS: The findings suggest that Tuberculosis Preventive Therapy did not show additional protection against TB for PLHIV on DBR, which may be associated with non-suppression. Additional study is recommended to further review the protection conferred by TPT among PLHIV.