Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania

Abstract

Background: The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied. Objective: To assess the TB incidence in HIV-infected adults and its associated risk factors. Method: A cohort study with retrospective review of medical records and prospective follow-up of HIV-infected adult participants attending CTC who were 18-55 years old, had CD4 count more than 250 cells/mm 3 in the period of 2008-2010 and were not on ART at enrolment. Cox proportional hazard regression was used to explore the predictors of incident TB. Results: Overall 777 (24%) of 3,279 CTC enrolled HIV-infected adults fulfilled the inclusion criteria of the study. The incidence of TB in the study population ranged from 0.8/100 per person years (PY) at risk (95% CI 0.5-1.3) in the main analysis to 1.7/100 PY at risk (95% CI 1.0-2.6) in sensitivity analyses. Only prior history of TB disease was found to have a significant association with an increased risk of TB, hazard ratio 5.7 (95% CI 2.0-16.4, p value 0.001). Conclusion: Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Previously TB treated patients have a much higher risk of getting TB again than those who never had TB before.

Determinants of Tuberculosis Among HIV Infected Adults in Horro Guduru Wollega Zone, West Ethiopia: A Facility-Based Case-Control Study

“…Other independent predictors of TB/HIV co-infection in this study were base line WHO clinical stage III & IV. This result is consistent with other studies done in different parts of Ethiopia (5,10,14,32), Tanzania (47).This might be due to the fact that once patients get into late stages, the immune protective capacity will be minimal, making them predisposed to TB infection. This suggests that those who are in WHO stage III & IV might be immune compromised and predisposed to TB (30).…”

Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

“…TB incidence rates found in our study are very high (5.41/100 PYs), higher than the TB incidence rates in the general HIV-positive population in our setting 4 . Our TB incidence is almost 10 times higher than the TB incidence rate found in a recent retrospective cohort analysis in Nigeria among HIV-positive patients initiating cART (0.57/100PYs) 38 and in a study in rural Tanzania (1.7/100PYs) 39 . Nevertheless, our figures are similar to those from a recent prospective cohort study, in South Africa, which reported a TB incidence rate of 5.4/100PYs in HIV-positive household contacts of TB patients 40 .…”

Tuberculosis and Human Immunodeficiency Virus Co-Infection: Clinico-Demographic Determinants at an Anti-Retroviral Therapy Center in Northern India

“…278 (54.72%) were observed to be in the age group of 35-59 years, out of which 150 (29.52 %), 19 Table 3]. [11,13,14,15] Dahiya et al reported 25-34 age group to be…”