Prevalence of HIV infection in patients hospitalized for tuberculosis in Bahia, Brazil

Abstract

HIV infection is an important risk factor for the development of tuberculosis (TB), and also affects its morbidity and mortality. This study estimated the prevalence of HIV infection in patients hospitalized for TB in Bahia (in northeastern Brazil) and to evaluate its impact on in-hospital mortality. A total of 375 patients with TB, admitted consecutively to a TB reference hospital in Salvador (Bahia, Brazil), were evaluated between July 2001 and July 2003. Anti-HIV serology was performed in all patients irrespective of clinical and/or epidemiological data suggestive of HIV infection. Death during hospitalization was the principal event-dependent variable. Mean age of patients was 41.4 ± 16.2 years and the male/female ratio was 3.4:1.0. The prevalence of HIV infection was 8.8% (95%CI: 6.2-12.0%). Patients in the HIV-positive group were younger than those in the HIV-negative group (37.1 versus 41.9 years; p=0.05). In-hospital mortality was 10.9% for the whole group (95%CI: 9.4-15.9%), but was significantly greater in the HIV-positive group compared to the HIV-negative group (27.3% versus 9.4%; RR=2.9; 95%CI: 1.5-5.6; p=0.002). The prevalence of HIV infection in patients hospitalized for TB in Bahia (northeastern Brazil) is relatively high (8.8%) and mortality is significantly higher (2.9-fold) in the HIV-positive group. These findings justify carrying out HIV testing, as recommended by the Brazilian Ministry of Health, in all TB patients, particularly those requiring hospitalization.

Factors related to HIV/tuberculosis coinfection in a Brazilian reference hospital

“…For this reason, individuals infected with HIV have increased susceptibility to active tuberculosis. HIV is the main risk factor for the development of TB [10,12,[16][17][18].…”

Human T Lymphotropic Virus and Pulmonary Diseases

“…This was also demonstrated in the Northeast Region of Brazil ( Moreira et al, 1993 ; Pedral-Sampaio et al, 1997 ; Marinho et al, 2005 ; Bastos et al, 2009 ) and in a study conducted in the Central-west region of Brazil, where the prevalence was higher than that observed in blood donors ( Kozlowski et al, 2014 ). In a study conducted with patients admitted to a hospital in Salvador, Brazil, 2 deaths were observed in HTLV-1 and tuberculosis coinfected patients ( Bastos et al, 2012 ).…”

“…The high prevalence of HTLV-1 among patients with pulmonary tuberculosis (PT) ( Moreira et al, 1993 ; Pedral-Sampaio et al, 1997 ; Marinho et al, 2005 ; Verdonck et al, 2008 ; Bastos et al, 2009 ; Kozlowski et al, 2014 ), high mortality rates among co-infected individuals, and increased likelihood of hospitalization and treatment for PT in patients with HTLV-1 ( Bastos et al, 2012 ) reinforce the hypothesis that individuals with HTLV-1 are at higher risk of infection with Mycobacterium tuberculosis ( Marinho et al, 2005 ; Grassi et al, 2016 ).…”

Mycobacterium tuberculosis in a HIV‐1‐infected population from Southeastern Brazil in the HAART era

“…Undoubtedly, TB ⁄ HIV co-infection persists as an important public health problem (Perkins & Cunningham 2007) and the numerous reports of increasing NTM infections point to the emergence of an additional concern. Sã o José do Rio Preto city (population 400 000) is one of the 12 cities with higher coefficients of TB ⁄ HIV cases (CVE 2006) in Sã o Paulo State and occupies the fifth place in AIDS incidence (CVE 2008 Matos et al 2004;Silveira et al 2006). As expected, the positive association between prison record and MT isolation (28.3%) found in this study was greater than that previously published (6.3%) for a TB ⁄ HIV-coinfected population from Rio Grande do Sul, Extreme South of Brazil (Mattos et al 2006 as the incidence index of the prison population in São Paulo State is 17.8 times higher than that of the general population (Nogueira & Abrahã o 2009).…”