Survival rate and predictors of mortality among TB/HIV co-infected adult patients: retrospective cohort study

Abstract

Nowadays, Tuberculosis remains the major cause of HIV-associated mortality, which accounts for 1 out of every 5 HIV-related mortality worldwide. This study aimed to determine the survival rate and predictors of mortality among TB/HIV co-infected patients. An institution-based retrospective cohort study was undertaken on adult TB/HIV co-infected individuals between 1st February 2014 and 30th January 2022 at Mettu Karl Referral Hospital. A Cox regression model was used to identify predictors of survival time to death among TB/HIV co-infected patients. This study comprised 402 TB and HIV co-infected adult patients. Among these, 84 (20.9%) died, and 318 (79.1%) were censored. The study subjects have been followed up for 6920 person-months with an overall median survival time of 17.6 months. The overall incidence rate was 12.1 per 1000 person months [95% CI: 9.77–14.98]. The results of a multivariable Cox regression analysis showed that being at an older age, urban residence, WHO clinical stage II & IV, CD4 count of ≥ 200 cells/mm3, bedridden functional status, using INH, and using CPT were associated with the survival time of TB and HIV co-infected patients at a significance level of alpha = 0.05. This retrospective study found that high mortality of TB/HIV co-infected patients occurred in the earlier months of treatment initiation. Close monitoring of patients with low CD4, who do not utilize CPT, who are in advanced WHO stages, and who have poor functional levels can help them improve their health and live longer.

RETRACTED: Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment

“…It was observed in the multivariable analysis that hazards of mortality increased by 3.11 times (95% CI: 1.19–1.44) and 2.11 times (95% CI: 1.94–2.30) in patients with baseline CD4 count ≤50 and baseline CD4 count 51–200, respectively, as compared to those who had baseline CD4 count >200. A similar retrospective cohort study done in Oromia region, Ethiopia, on a large population of 2,775 individuals with HIV reported lower mortality (AHR = 0.719; 95% CI: 0.536–0.966) among individuals with CD4 count compared to people living with HIV with CD4 count more than 200 cells/mm 3 ( 35 ). Several studies have found a significant relationship between CD4 cell count and survival rates, implying that a low CD4 cell count is associated with an increased risk of mortality ( 36 – 38 ).…”

Tuberculosis in Regional Australia: Ectopic Pregnancy Complicating Indolent Genital Tract Disease

“…Tuberculosis (TB) is a significant cause of morbidity and mortality worldwide [6], with estimates from the World Health Organization suggesting 10 million cases in 2020 alone [7]. Tragically, in the absence of adequate treatment, 5-year survival is less than 50% [8]. The geographic distribution of TB varies widely, with two-thirds of the global burden concentrated in third-world nations [9].…”

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

“…Various studies have demonstrated the harmful interactions between HIV and TB, which negatively impact population health [ 4 ]. For instance, research conducted in Africa revealed that the HIV and TB epidemics are intertwined [ 5 ], while a study in Ethiopia uncovered a two-way relationship between these two diseases [ 6 ]. The detrimental and reciprocal effects of HIV and TB are evident at both individual and population levels, particularly in sub-Saharan African nations [ 7 ].…”