Prevalence and Risk Factors of Active TB among Adult HIV Patients Receiving ART in Northwestern Tanzania: A Retrospective Cohort Study

Abstract

Introduction Although ART has improved the outcome of people living with HIV/AIDS, still some patients develop TB while receiving ART. The literature on the magnitude of this problem is still scarce in our setting especially northwestern Tanzania. This study was designed to determine the prevalence of active TB among HIV patients on ART and assess its potential risk factors. Methods A retrospective cohort study was done among adult HIV-positive patients initiated on ART at Bugando Medical Centre. Patients who were TB positive before ART initiation were excluded. Data regarding demographic, clinical, and laboratory information, TB status on receipt of ART, and time on ART were collected and analyzed using STATA 11 to determine the prevalence of TB and its associated factors. Results In total, 391 patients were enrolled in this study. The median age was 39 (32–46) years, and a total of 129 (32.99%) participants had CD4 counts <200 cells/µl and 179 (45.78%) had WHO stage 3 and 4 illnesses. A total of 43 (11.0%) participants developed TB while receiving ART which was independently associated with male gender (OR = 2.9; p=0.007), WHO clinical stage 3 and 4 (OR = 1.4; p=0.029), baseline CD4 count <200 cells/µl (OR = 9.1; p < 0.001), and having not used IPT (OR = 3.1; p=0.05). Conclusions Active TB is prevalent among HIV patients while receiving ART in northwestern Tanzania which is independently associated with male gender, advanced HIV disease, and nonuse of IPT. Universal HIV testing could reduce late HIV diagnosis and hence reduce the risk of developing TB while receiving ART in our setting. Also IPT should be widely used for those who are negative for TB on screening.

Successful implementation of isoniazid preventive therapy at a pediatric HIV clinic in Tanzania

“…Tuberculosis (TB) represents an enormous global disease burden, especially for people living with human immunodeficiency virus (HIV) [ 1 , 2 ]. Rates of TB disease are particularly high in children living with HIV [ 3 , 4 ].…”

Predictors of Hiv Infection Progression Before Prescription and on Art

“…Способствуют развитию железодефици-тных состояний: хронические кровопотери, повышенная потребность в железе при некоторых физиологических состояниях (подростковый возраст и беременность), недостаточное поступление железа с пищей, нарушение всасывания железа [5,6,7]. К симптомам и признакам дефицита железа без анемии можно отнести ухудшение физической работоспособности, снижение когнитивных функций, усталость, головную боль, головокружение, одышку, синдром беспокойных ног, выпадение волос, ангулярный стоматит, глоссит, в том числе и атрофический [8] и снижение либидо. Другие особенности включают увеличение частоты осложнений во время беременности,…”

“…Станом на сьогодні встановлений вплив численних факторів на прогресування ВІЛ-інфекції, пов'язаних як безпосередньо з ВІЛ -тяжкість імуносупресії, вірусне навантаження (ВН) ВІЛ [6], так і з біологічними [ 7], поведінковими [8] та генетичними особливостями організму хазяїна [9]. Однак питання виявлення предикторів прогресування ВІЛ-інфекції залишається недостатньо вивченим, що і стало предметом нашого дослідження.…”

Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

“…Tuberculosis (TB) disease is common among people living with HIV (PLHIV), with the lifetime risk of acquiring disease 20-37 times higher compared to people who are HIV negative (1)(2)(3)(4)(5). Tuberculosis co-infection increases the consequences of the HIV burden and contributes to 30-40% of deaths among PLHIV in high endemic regions (6)(7)(8)(9). Globally TB/HIV co-infection is a major public health concern with more than1 million PLHIV co-infected with TB in the year 2017 (7,10), and 78% of those conifected with TB living in Africa (7).…”