This project aims to assess a clinical scoring system for evaluation of immunosuppression in HIV-infected patients with tuberculosis (TB) in Ethiopia. The score contains 15 items based on clinical examination. Results of scoring will be correlated with CD4 cell counts, recommended CD4 cut-off levels for initiation of antiretroviral therapy (ART) and TB treatment outcome. At diagnosis of TB, patients will undergo HIV testing and clinical scoring. HIV-positive participants will be followed longitudinally with repeated scoring and CD4 cell testing. HIV-negative TB patients will serve as a control group. Blood for further immunological analyses will be collected. Finding simple alternative methods for assessment of TB/HIV co-infected patients could improve management and facilitate scaling up of ART and integration to peripheral levels of the health care system in resource-limited settings. |