Treatment outcomes and factors associated with mortality among individuals with both TB and HIV in the antiretroviral era in Thailand

Sivaporn Gatechompol; Kamon Kawkitinarong; Gompol Suwanpimolkul; Pairaj Kateruttanakul; Weerawat Manosuthi; Jiratchaya Sophonphan; Sasiwimol Ubolyam; Stephen J Kerr; Anchalee Avihingsanon; Kiat Ruxrungtham

Treatment outcomes and factors associated with mortality among individuals with both TB and HIV in the antiretroviral era in Thailand

J Virus Erad. 2019 Nov 4;5(4):225-230.

Authors

Sivaporn Gatechompol, Kamon Kawkitinarong, Gompol Suwanpimolkul, Pairaj Kateruttanakul¹, Weerawat Manosuthi², Jiratchaya Sophonphan³, Sasiwimol Ubolyam, Stephen J Kerr^{3

4}, Anchalee Avihingsanon, Kiat Ruxrungtham^{3

4}

Affiliations

¹ Department of Medicine, Rajavithi Hospital, Bangkok, Thailand.
² Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand.
³ HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
⁴ Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

PMID: 31754446
PMCID: PMC6844402

Abstract

Objective: This study aimed to compare treatment outcomes and factors associated with mortality in HIV-1-positive and HIV-1-negative individuals.

Methods: We conducted a cohort study between July 2008 and December 2016. Logistic regression was used to determine factors associated with outcomes and death after tuberculosis (TB) treatment.

Results: A total of 996 individuals with TB, 228 (22.9%) with HIV-1 co-infection and 770 (77.1%) who were HIV-1 negative were reviewed. The overall treatment success rate was 74.3%. The HIV-1-negative individuals with TB had significantly higher treatment success rates (77.2% vs 64.5%, P < 0.001). Using logistic regression analysis, age >50 years (adjusted odds ratio [aOR] 3.89, 95% confidence interval [CI] 2.24-6.76; P < 0.001), body weight ≤45 kg (aOR 2.19, 95% CI 1.14-4.19; P = 0.02) and HIV-1-positive status (aOR 3.31, 95% CI 1.84-5.91; P < 0.001) were independently associated with death during TB treatment. Among HIV-1-positive individuals, not undergoing antiretroviral therapy (ART), having diabetes and a CD4 T cell count of <50 cells/mm³ were significantly associated with death.

Conclusion: Individuals who had both TB and HIV-1 in Thailand had lower TB treatment success and higher mortality rates compared with individuals with TB without HIV-1. Strategies to improve ART uptake and to reduce risk of developing active TB among individuals with advanced HIV-1 infection should be scaled up.

Keywords: TB/HIV; antiretroviral therapy; risk factors; treatment outcome.

Publication types

Editorial