Tuberculosis infection in HIV vs. non-HIV patients

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Tuberculosis (TB) is a leading cause of mortality in people living with HIV (PLWH).
• Understanding the interplay between TB and HIV is crucial for managing both infections.
• Differences in clinical presentation and risk factors between HIV-coinfected and non-coinfected TB patients require further characterization.

Purpose of the Study:

• To compare demographic and clinical characteristics of TB patients with and without HIV coinfection.
• To identify specific risk factors and TB disease patterns associated with HIV coinfection.
• To inform clinical management strategies for TB in PLWH.

Main Methods:

• A retrospective, cross-sectional study analyzing electronic medical records of TB patients admitted between 2011 and 2016.
• Comparison of HIV-coinfected TB patients with non-HIV TB patients based on demographic and clinical data.
• Inclusion of 591 patients, with 32% diagnosed with HIV coinfection.

Main Results:

• HIV-TB patients were younger, predominantly male, and exhibited higher rates of homelessness and intravenous drug use.
• Disseminated TB and a history of prior TB infection were more common in the HIV-coinfected group.
• Cancer was the primary cause of immunosuppression in HIV-TB patients; microbiological culture positivity was lower, but mortality and resistance rates were comparable between groups.

Conclusions:

• HIV coinfection is associated with specific demographic and clinical features in TB patients, including younger age and disseminated disease.
• Despite differences in presentation, microbiological resistance and in-hospital mortality rates were similar between HIV-coinfected and non-coinfected TB patients.
• Further research and tailored management approaches are needed for TB in PLWH, particularly in regions with moderate TB incidence.