Contribution of provider initiated testing and counselling of hiv in detecting new hiv cases under revised national tuberculosis control programme in telangana state, india

Background: According to TB India 2017 report, an estimated 0.11 million were HIV-positive among the 2.8 million people who developed TB in India in 2015 and nearly 37,000 deaths were among HIV-TB co-infected. In 2013, the concept of Provider Initiated Testing and Counselling for HIV has been introduced in India under RNTCP. Objectives: This study makes an attempt to find out the utility of PITC in identifying incremental detection of HIV positive cases during 2013-16. Methods: PITC is implemented since Jan 2013 in entire Telangana State, through Integrated Counselling and Testing Centres. Towards this good linkage between of ICTC and DMC services was ensured. Task shifting of HIV testing to RNTCP Lab Technicians was ensured wherever NACP LTs were not available. A desk review of both programmes was done for PITC screening. Results: A total of 157640 (97%) were tested for HIV from 163248 total registered TB patients under RNTCP and identified 9748 (6.2%) HIV positives. Of 826186 presumptive TB cases, 682147 (83%) were tested for HIV as part of PITC which resulted in identification of 38714 (5.8%). It is demonstrated that there is an additional yield of 29966 (3.1 times higher) HIV cases under RNTCP due to PITC. Conclusions and Recommendations: PITC must be implemented in all high HIV prevalent settings which can contribute to early detection of HIV cases and help in early initiation of Co-trimoxazole prevention therapy and antiretroviral therapy and thus reducing morbidity and mortality among PLHIV. This can in turn contribute to reduction in transmission of TB as the risk of getting TB is very high in PLHIV.