Free Content Tuberculosis and human immunodeficiency virus co-infections and their predictors at a hospital-based HIV/AIDS clinic inUganda

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Abstract:

SETTING: Mulago Hospital, Uganda.

OBJECTIVE: To evaluate the burden of TB-HIV (tuberculosis-human immunodeficiency virus) co-infections and their predictors in an urban hospital-based HIV programme.

DESIGN: Prospective observational study.

METHODS: Clinicians screened all patients with HIV/AIDS (acquired immune-deficiency syndrome) for previous and current TB treatment at enrolment and throughout follow-up.

RESULTS: Of 10 924 patients enrolled between August 2005 and February 2009, co-prevalent TB was 157/10 924 (1.4%), which included 88/157 (56%) with TB confirmed at enrolment and 65/157 (41%) with TB diagnoses established during follow-up in whom symptoms were present at enrolment. Male sex (adjusted odds ratio [aOR] 2.3, 95%CI 1.6–3.2) and body mass index (BMI) ≤20 kg/m2 (aOR 3.8, 95%CI 2.5–5.4) were associated with co-prevalent TB. Overall, 749/10 767 (7%) were diagnosed with incident TB at a higher rate among antiretroviral treatment (ART) patients (8/100 patient years of observation [PYO]) than non-ART patients (5/100 PYO, log rank P < 0.001). Female sex (adjusted hazard ratio [aHR] 1.4, 95%CI 1.2–1.7) and baseline BMI ≤ 20 (aHR 1.9, 95%CI 1.6–2.2) predicted incident TB.

CONCLUSION: Routine TB screening in the HIV/AIDS care programme identified a significant number of TB-HIV co-infections among patients with and without ART, and is therefore a potential strategy to improve HIV treatment outcomes in resource-limited settings.

Keywords: ART; Africa; HIV/AIDS; TB-HIV co-infections; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, Makerere University School of Medicine, Kampala, Uganda 2: Mulago-Mbarara Teaching Hospitals' Joint AIDS Program (MJAP), Kampala, Uganda 3: Department of Clinical Sciences, HIV/STD Unit, Institute of Tropical Medicine, Antwerp, Belgium; and Faculty of Medicine, University of Antwerp, Antwerp, Belgium

Publication date: December 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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