Incidence and Risk Factors of ActiveTuberculosis in HIV Patients After Antiretroviral Treatment
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Abstract
Background: Tuberculosis is the leading cause of death in Thailand. This study aimed to identify the incidence and risk factors associated with active tuberculosis in HIV-infected patients after starting antiretroviral therapy.
Methods: A retrospective cohort study was conducted and collected data from medical records in all HIV-infected patients who received antiviral therapy in Surin Hospital between January 2007 until December 2017. We reported the incidence of new diagnosis tuberculosis and identified associated factors by logistic regression analysis.
Results: A total of 1,610 patients who received antiretroviral therapy and followed up in our institute until December 2017 were included in the study. Eight hundred and forty cases (52.1%) were male. The mean age was 42.0 ± 11.6 years, mean body weight was 55.6 ± 10.6 kilograms and a median of initial CD4 cell count was 234 cells/mm3 (IQR 88-400). Most patients have been treated with median duration of antiretroviral therapy 85.2 months (IQR 36.8-128.0). One hundred and nine patients (6.8%) had a previous history of tuberculosis. There were 20 patients diagnosed with tuberculosis after antiretroviral therapy initiation. The previous history of tuberculosis (adjusted odds ratio, 3.41; 95% CI, 1.10 to 10.48) was correlated with statistical significance. The initial CD4 less than 200 cells/mm3 (adjusted odds ratio, 1.89; 95% CI, 0.73 to 4.88) and male gender (adjusted odds ratio, 1.31; 95% CI, 0.50 to 3.44) were also correlated but not statistical significance.
Conclusions: The incidence of tuberculosis in HIV-infected patients after antiretroviral therapy initiation was 0.159 per 100 persons-year and who had a previous history of tuberculosis and low initial CD4 cell count are strong risk factors.
Keywords: tuberculosis, HIV-infected patient, CD4
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References
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