Predictors for tuberculosis co-infection in people living with HIV/AIDS

Abstract

Background/aim: Tuberculosis (TB) is one of the most common chronic infectious conditions causing mortality and se- vere outcomes, particularly in people living with HIV/AIDS (PLWHA). In this study, we aimed to determine the prevalence and predictors of TB among PLWHA.
 Materials and methods: We conducted a retrospective and single-center study of adults (≥18 years) PLWHA registered at our tertiary teaching and research hospital between 2000 and 2016.
 Results: A total of 711 PLWHA were included. Of whom, 633 (89.0%) were male. Mean age was 36.53 ±11.55 years (range, 17-79). Thirty-eight (5.3%) patients were diagnosed with active TB. TB development was associated with low CD4+ lymphocyte count (p<0.001), high viral load (p=0.040) and alcohol consumption (p=0.004) but no association with age (p=0.392), gender (p=0.928) and duration since anti-retroviral therapy initiation (p=0.788) was found. Also, a receiver operating characteristic analysis showed that the area under the curves of CD4+ lymphocyte count as a predictor for TB development in PLWHA was 0.717 (p<0.001).
 Conclusion: There are still clinical challenges to predict TB diagnosis. However, CD4+ lymphocyte count and viral load may be considered as valuable predictors for TB development. Also, community strategies to reduce harmful effect of alco- hol use should be developed.
 Keywords: Tuberculosis; HIV viral load; CD4 cell counts.

Prevalence, treatment outcomes and determinants of TB/HIV coinfection: A 4-year retrospective review of national tuberculosis registry in a country in a MENA region

“…Meanwhile, other studies investigating TB/HIV coinfection have reported different rates of infection, such as a study in Nigeria that reported a 22.50% coinfection rate among TB patients over 5 years [ 30 ], or a study in Kenya, conducted by Wekunda et al that reported a 35.00% coinfection rate [ 31 ]. Another study conducted on HIV/AIDS patients over 18 years of age in Turkey found that 5.30% of these patients had active tuberculosis at the same time [ 32 ], while a study in China, done by Wang et al that examined only EPTB patients reported a 7.00% coinfection rate [ 33 ], compared to 2.00% in the present study. The differences in these results may be due to variations in population groups in different geographical areas, periods, and inclusion and exclusion criteria used in different studies.…”

“…The results of this study showed that SNPTB patients had the highest proportion (37.05%) of TB/HIV coinfection, followed by EPTB patients with 18.19%. However, in several other studies, TB/HIV coinfection was found to be more common in PTB patients [ 32 , 41 ], and even this result was repeated in a study examining HIV patients as well [ 35 ]. However, in these studies, PTB patients were not categorized based on the positive or negative result of sputum smear.…”

“…The present study found that the highest number of TB/HIV coinfection was observed in single patients, which is consistent with the findings of a study conducted by Jalal et al in Malaysia [ 40 ]. However, in studies by Audu et al in Nigeria [ 42 ], and Zerdali et al in Turkey [ 32 ], the highest incidence of active TB among HIV-positive patients was reported in married individuals. The difference in results may be due to variations in geographical and cultural differences among the studied samples, as well as differences in the definition of marital status classification mentioned in these studies.…”

Opportunistic Infections Among Human Immunodeficiency Virus (HIV) Infected Patients in Turkey: A Systematic Review

“…Among the studies, overall mortality rates of all patients with HIV/AIDS ranged between 0.8% to 36%. In terms of tuberculosis, the overall mortality was calculated as 18% in patients with AIDS and tuberculosis ( 9 , 10 , 12 , 34 , 37 , 39 ). In addition, the median CD4 + T lymphocyte count was 181.5/mm 3 , and the median HIV-1 RNA was 127,620 copy/mL among AIDS patients with tuberculosis (Table Table 3 ).…”

Editorial: TB on the rise: but researchers are not sleeping

“…This is followed by the twin infection of TB and HIV. Esra Zerdali and others 5 investigate the factors associated with this co-nfection. Work from Ethiopia 6 also discusses TB and HIV co-infection and arrives at fairly similar conclusions: that marital status, education level, CD4 cell count and clinical stage of the HIV were associated with HIV/TB coinfection.…”