Relación entre conteo de linfocitos TCD4, carga viral y riesgo de tuberculosis en pacientes con VIH/SIDA atendidos durante 2023 en el Hospital Teodoro Maldonado Carbo.

Abstract

Introduction: The human immunodeficiency virus (HIV) compromises the immune system by reducing CD4 T cell levels, which predisposes to opportunistic infections, with tuberculosis being one of the most common and lethal. The impact of HIV-tuberculosis co-infection is bidirectional. By increasing the viral load, tuberculosis accelerates the progression of HIV infection to AIDS and, with it, death. For its part, HIV infection causes a decrease in the CD4 lymphocyte population and affects the clinical presentation and evolution of tuberculosis. Objective: To relate the CD4 T cell count, viral load, and risk of tuberculosis in HIV-infected patients treated during 2023 at the Teodoro Maldonado Carbo Hospital. Materials and Methods: This research is retrospective, observational, crosssectional, and descriptive. The data collection method was done through documentation of the medical records with tuberculosis and HIV+ of the Teodoro Maldonado Hospital, during the year 2023. The data were stored in Excel and later through the SPSS 25 program, measures of central tendency, and measures of dispersion, Odds Ratio and Chi Square were used. Results: 6028 medical records with a diagnosis of HIV were obtained. A manual filtering of this population was performed to obtain the patients who had Tuberculosis added as a diagnosis. We obtained 118 medical records, and according to inclusion and exclusion criteria, the study population finally included 100 cases diagnosed with both tuberculosis and HIV. Statistical analysis revealed a significant association between CD4 count and viral load (VL), with a p value < 0.001. This confirms the hypothesis that the level of immunosuppression, measured through the CD4 count, has a direct impact on the ability of patients to control viral replication. However, the relationship between CD4 count and the presence of tuberculosis (BK) was not statistically significant with a p value = 0.135. A higher prevalence of tuberculosis was expected in patients with low CD4 levels due to their greater susceptibility to opportunistic infections. Conclusion: This study reinforces the idea that HIV control, as measured by viral load and CD4 count, is highly variable and influenced by various factors. While there is a clear relationship between CD4 count and VL, no statistically significant association was found between CD4 and positivity to Koch's bacillus. The results suggest the need to continue evaluating additional factors that may be affecting the prevalence of tuberculosis in HIV patients, and reinforce the importance of ongoing monitoring and an individualized treatment approach to improve clinical outcomes.