Molecular detection of pulmonary tuberculosis and Candida albicans co-infection in people living with HIV/AIDS in Nigeria

Abstract

OBJECTIVES: Concurrent pulmonary tuberculosis (PTB) and antifungal-resistant candidiasis pose significant clinical and public challenges in resource-limited settings. This study determined the prevalence of PTB and antifungal-resistant Candida albicans co-infection among people living with HIV/AIDS (PLWHA) in Gombe State, Nigeria. METHODS: Sputum samples from 348 PLWHA were processed and tested for Mycobacterium tuberculosis using GeneXpert equipment. Moreover, C. albicans was isolated and identified using CHROMagar, germ tube test, and 18S rRNA-ITS-PCR sequencing, and its antifungal susceptibility patterns were determined by the disc diffusion method. RESULTS: The prevalence values for C. albicans, PTB, and C. albicans-PTB co-infections were 9.2%, 9.2%, and 6.3%, respectively. All Mycobacterium tuberculosis strains were rifampicin-susceptible but were significantly associated with age (P = .0033) and biological sex (P = .03). About 40.6%, 31.3%, and 28.1% of the C. albicans strains were resistant to fluconazole, voriconazole, and amphotericin-B, respectively. PLWHA aged >60 years had significantly higher odds of C. albicans infection (OR = 54.6, P = .0156). History of antibiotic use, pet ownership, and presence of PTB were significantly associated with C. albicans (P < .05). About 87.5% of PLWHA with C. albicans had CD4⁺ T-cell counts of <200 cells/mm³. CONCLUSION: The levels of PTB and C. albicans mono- or co-infections among PLWHA were moderate, with a high frequency of fluconazole-resistant C. albicans. This study provided updated local surveillance data on pulmonary infections among PLWHA.