Tuberculosis: clinical manifestations and outcomes

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) remain significant global health challenges.
• Tuberculosis (TB) is an opportunistic infection that disproportionately affects individuals with HIV/AIDS.
• Understanding the characteristics and outcomes of TB in HIV/AIDS patients is crucial for effective public health interventions.

Purpose of the Study:

• To describe the demographic, clinical, and risk factor profiles of HIV/AIDS patients with tuberculosis.
• To analyze the diagnostic criteria and clinical outcomes of tuberculosis in this patient population.
• To identify challenges in TB management among HIV/AIDS patients, including treatment completion and loss to follow-up.

Main Methods:

• Retrospective study design.
• Recruitment of 290 HIV/AIDS patients diagnosed with tuberculosis at the National Tuberculosis Center (NTBC), Kuala Lumpur.
• Data collection on demographics, risk factors, clinical manifestations, CD4 cell counts, diagnostic methods, and treatment outcomes.

Main Results:

• The majority of patients were male (96.9%), Malay (47.2%), unemployed (81%), and identified injecting drug use (74.5%) as the primary risk factor.
• Pulmonary tuberculosis was diagnosed in 85.9% of patients, with common symptoms including cough, fever, and sputum.
• A significant proportion of patients (54.8%) were lost to follow-up, and 16.9% had CD4 cell counts below 200 cells/mm³.

Conclusions:

• Injecting drug use is a major risk factor for tuberculosis in HIV/AIDS patients.
• High rates of loss to follow-up and suboptimal treatment completion highlight significant challenges in managing TB in this vulnerable population.
• Improved adherence support and integrated care strategies are needed to improve TB treatment outcomes in HIV/AIDS patients.