Negative Impact Factors in HIV-Tuberculosis

About one quarter of all tuberculosis (TB) deaths are among people living with HIV. Tuberculosis is a leading infectious cause of death among persons infected with HIV and the outcome of TB treatment is poorer in these patients. Objective: To identify the factors associated with a poor tuberculosis outcome in patients with HIV-TB coinfection. Material and methods: This is a retrospective cohort study using data from the local TB registry for 2009-2016. We performed descriptive statistics as well as univariate and multivariate analysis. Results: During the study period we identified 86 patients (4.76% of all patients registered for TB treatment) with HIV-TB who had a mean age of 35.05±9.10 years and were mostly male (73.25%). More than half of patients were current drug users (51.16%) and 22.10% homeless. The mean CD4 value was 179.11±204.76/mm3 and 69.76% of patients received antiretroviral treatment during TB treatment. Viral hepatitis was present in 61.62% of cases, and 77.9% of patients were new TB cases. Pulmonary TB was noted in 72 cases, with confirmation by culture being obtained in 84.44% of cases. Treatment success was achieved in 63.95% of cases, 22.09% of patients died, 8.13% abandoned treatment, and 5.81% were lost to follow up. Several factors related to poor outcome were identified by univariate analysis, including drug use (OR=3.14, p=0.027), homeless status (OR=3.01, p=0.039) and viral hepatitis (OR=2.93, p=0.045). Multivariate analysis revealed marginal insignificance for homeless status (p=0.06) and drug use (p=0.86). Conclusion: A special attention and dedicated programs should be considered for patients who are intravenous drug users or those without a stable home.