Human immunodeficiency virus and tuberculosis coinfection: clinical features and predictors of mortality

Abstract

Background/aim: This study was undertaken to identify subjects with human immunodeficiency virus and tuberculosis (HIV/TB) coinfection in a group of HIV-positive patients followed at five different healthcare centers, and to determine the demographic and clinical characteristics of these subjects as well as the predictors of mortality. Materials and methods: A database search for subjects with TB coinfection was performed among 1475 HIV-positive adult patients and a total of 66 individuals were identified with HIV/TB coinfection. Results: There were 66 patients (4.5%) with TB coinfection. Twenty-one percent (n = 14) of the patients with TB coinfection died during the study period and these patients had significantly lower baseline CD4 counts at the time of TB diagnosis (P = 0.005). None of the patients with CD4 count of ≥200 cells/mm3 died during follow-up and a low CD4 count at the time of TB diagnosis (<200 cells/ mm3) was associated with poor survival (P = 0.012). However, none of the parameters emerged as significant independent predictors of survival in multivariate analysis. Conclusion: Coexistence of TB and HIV infection is associated with many clinical challenges and a better understanding of patient characteristics as well as the parameters impacting the outcome will improve the quality of care provided for this group of patients.

Predictors for tuberculosis co-infection in people living with HIV/AIDS

“…Of the patients, about a quarter had a CD4+ T lymphocyte count of less than 200 cells/mm 3 and about a half had more than 350 cells/mm 3 . This finding was consistent with the study of Gumuser et al 11 . Also, in the study of Lawn et al, CD4+ cell counts were the dominant predictor of TB development during ART8.…”

“…Also, in the study of Lawn et al, CD4+ cell counts were the dominant predictor of TB development during ART8. HIV infection is associated with deterioration of cellular immune responses and increased risk of opportunistic infections via reduced CD4+ T lymphocyte count 11 . In the study of Dravid et al, virologic failure on ART was associated with a higher risk for TB development9.…”

Opportunistic Infections Among Human Immunodeficiency Virus (HIV) Infected Patients in Turkey: A Systematic Review

“…Among the studies, overall mortality rates of all patients with HIV/AIDS ranged between 0.8% to 36%. In terms of tuberculosis, the overall mortality was calculated as 18% in patients with AIDS and tuberculosis ( 9 , 10 , 12 , 34 , 37 , 39 ). In addition, the median CD4 + T lymphocyte count was 181.5/mm 3 , and the median HIV-1 RNA was 127,620 copy/mL among AIDS patients with tuberculosis (Table Table 3 ).…”