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

Afr Health Sci. 2021 Sep;21(3):995-1002. doi: 10.4314/ahs.v21i3.6.

Abstract

Background/aim: Tuberculosis (TB) is one of the most common chronic infectious conditions causing mortality and severe outcomes, particularly in people living with HIV/AIDS (PLWHA). In this study, we aimed to determine the prevalence and predictors of TB among PLWHA.

Materials and methods: We conducted a retrospective and single-center study of adults (≥18 years) PLWHA registered at our tertiary teaching and research hospital between 2000 and 2016.

Results: A total of 711 PLWHA were included. Of whom, 633 (89.0%) were male. Mean age was 36.53 ±11.55 years (range, 17-79). Thirty-eight (5.3%) patients were diagnosed with active TB. TB development was associated with low CD4+ lymphocyte count (p<0.001), high viral load (p=0.040) and alcohol consumption (p=0.004) but no association with age (p=0.392), gender (p=0.928) and duration since anti-retroviral therapy initiation (p=0.788) was found. Also, a receiver operating characteristic analysis showed that the area under the curves of CD4+ lymphocyte count as a predictor for TB development in PLWHA was 0.717 (p<0.001).

Conclusion: There are still clinical challenges to predict TB diagnosis. However, CD4+ lymphocyte count and viral load may be considered as valuable predictors for TB development. Also, community strategies to reduce harmful effect of alcohol use should be developed.

Keywords: CD4 cell counts; HIV viral load; Tuberculosis.

MeSH terms

  • Acquired Immunodeficiency Syndrome*
  • Adult
  • CD4 Lymphocyte Count
  • Coinfection* / epidemiology
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tuberculosis* / complications
  • Tuberculosis* / diagnosis
  • Tuberculosis* / epidemiology
  • Young Adult