Risk Factors for Unfavorable Treatment Outcomes among the Human Immunodeficiency Virus-Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017

Abstract

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management.

Tuberculosis treatment during the COVID-19 pandemic: actions offered and case profile

“…TB-HIV co-infection is widely investigated and potentially threatening to the patient, as HIV makes its carrier susceptible to TB infections and complications due to the immunodeficiency caused by the virus in the body (18,21,22) . In this study, people with HIV received fewer healthcare actions compared to people who do not carry the virus.…”

Tuberculosis Death Epidemiology and Its Associated Risk Factors in Sabah, Malaysia

“…Strengthening TB/HIV control program integration is crucial to improve case management of TB–HIV co-infected patients. Studies conducted elsewhere that showed favorable treatment outcomes of between 79.8% [ 5 ] and 89.8% [ 15 ] can be achieved with the targeted clinical management of TB–HIV co-infected patients, specifically for those with other risks.…”

“…Studies looking into factors associated with TB deaths have been carried out worldwide in high and low TB incidence countries, and have found important factors which include patients’ sociodemographic characteristics, TB disease characteristics, TB treatment characteristics, and underlying comorbidities [ 4 , 5 ]. However, the findings are different between countries and regions.…”

Risk Factor for Retreatment Episode on Admission Among TB Patients With Schizophrenia

“…This point also supports extrapulmonary TB as a protective factor for retreatment episodes. Nevertheless, in most studies, it is thought that extrapulmonary TB is an independent risk factor for unfavorable events ( 39 – 42 ). The disagreement may be attributed to more care given to these patients and the rarity of severe forms of extrapulmonary TB [such as miliary TB (2.1 vs. 6.6%) and tuberculous meningitis (5.3 vs. 6.8%)], in comparison with data from Pang et al ( 43 ).…”