Prevalence and Clinical Outcomes of HIV and Tuberculosis Co-Infection at a Tertiary Hospital in Kano State

Tuberculosis (TB) is the leading cause of death in people living with HIV globally, and the clinical management of HIV-TB co-infection requires integrated virological and microbiological approaches. In Kano State, North West Nigeria, where both TB and HIV prevalence are significant, data on HIV-TB co-infection patterns and clinical outcomes at tertiary level are limited. This study determines the prevalence of HIV-TB co-infection and compares clinical outcomes (including ART initiation, TB treatment completion, and mortality) between co-infected and HIV-mono-infected patients at Aminu Kano Teaching Hospital. A retrospective cohort study will extract five years of records (2019 to 2024) from the hospital's TB and HIV treatment databases, using a deterministic matching algorithm to identify co-infected patients. Primary outcomes will include six-month TB treatment success rate, 12-month survival rate, and one-year viral suppression rate among co-infected patients. Secondary analysis will compare CD4 count at ART initiation and IRIS incidence rates. Cox regression analysis will adjust for confounders including age, sex, baseline CD4 count, and comorbidities. The limited published data from Kano suggest HIV prevalence among TB patients of 8 to 15 percent, though clinical outcome data by co-infection status are absent. Findings will characterise the HIV-TB disease burden at AKTH and inform protocols for integrated HIV-TB care in the largest tertiary hospital in northern Nigeria. Keywords: HIV-TB co-infection, clinical outcomes, Kano State, antiretroviral therapy, tuberculosis