Prevalência e fatores associados à tuberculose em pacientes soropositivos para o vírus da imunodeficiência humana em centro de referência para tratamento da síndrome da imunodeficiência adquirida na região sul do Rio Grande do Sul

Abstract

Objective: In view of the relevance of co-infection with tuberculosis and human immunodeficiency virus, this study was designed to determine tuberculosis prevalence and identify factors related to tuberculosis in patients residing in a region in which both infections are highly prevalent. Methods: All patients treated during 1999 at the HIV/AIDS Clinic of the Universidade Federal do Rio Grande (Rio Grande Federal University) University Hospital were evaluated retrospectively, from the time of human immunodeficiency virus diagnosis, in terms of the incidence of tuberculosis and its relationship to sociodemographic, behavioral and immunological factors. Results: The sample included 204 patients, and tuberculosis prevalence was found to be 27%. The multivariate analysis showed a significant correlation between the development of tuberculosis and being of African descent (odds ratio: 4.76; 95% confidence interval: 1.93-11.72) and an inverse correlation between the development of tuberculosis and the TCD4+ lymphocyte count at the time of human immunodeficiency virus diagnosis (odds ratio: 0.995; 95% confidence interval: 0.993-0.997). When analyzed separately, other variables were found to be potential risk factors: being of the male gender (odds ratio: 2.49; 95% confidence interval: 1.15-5.39); and using illicit drugs (odds ratio: 2.1; 95% confidence interval: 1.02-4.31). Conclusion: The factors responsible for the development of tuberculosis among patients who are human immunodeficiency virus seropositive include immunological, socioeconomic and demographic factors. The high rate of tuberculosis prevalence among the seropositive patients underscores the urgent need to implement strategies that combine rapid identification and prompt treatment of individuals with active or latent infection, as well as of those with whom they have been in contact.

The epidemiological dimension of TB/HIV co-infection

“…The predominance of co-infected men confirms the results of studies carried out in Brazil (9)(10)(11) . The reason men are predominantly getting infected is not very clear but it might be related to biological factors, life style, self-care (7) and also to the fact that men search for health services later than women (12) .…”

A study of gender differentials in the prevalence of tuberculosis based on NFHS-2 and NFHS-3 data

“…(9) in a sample of 204 HIV diagnosed cases, tuberculosis prevalence was reported to be 27%. It was also mentioned that the variables which were found to be potential risk factors were being of the male gender [odds ratio 2.49, confidence interval 1.15-5.39] and using illicit drugs [odds ratio 2.1, 95% confidence interval 1.02-4.31].…”

The first ten years: achievements and challenges of the Brazilian program of universal access to HIV/AIDS comprehensive management and care, 1996-2006

“…To a lesser extent, co-infections with Mycobacterium tuberculosis declined as well 52 , but remain as a major cause of morbidity and mortality of Brazilian AIDS patients 53 .…”