TITLE:
Impact of HIV Status, CD4 Count and Antiretroviral Treatment on Tuberculosis Treatment Outcomes in a Low-Burden Country
AUTHORS:
Vera Clérigo, Teresa Mourato, Conceição Gomes, Ana Castro
KEYWORDS:
Tuberculosis Treatment Outcomes, HIV Infection
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.6 No.4,
November
15,
2018
ABSTRACT: Background: Few data is available in low-burden TB-HIV countries on TB treatment outcomes. We evaluated TB patients (pts) characteristics by HIV status and compared treatment outcomes in relation to HIV status, CD4 count and antiretroviral therapy (ART). Methods: We performed a retrospective analysis of 447 adult TB pts who registered and initiated treatment in our center from 2014 to 2015. Results: Pts were categorized as HIV-negative (n = 399, 89.3%), HIV-positive on ART (n = 42, 9.4%) and HIV-positive not on ART (n = 6, 1.3%). The proportion of pts with extended TB therapy was higher among HIV-positive pts (p = 0.03). Increased age was associated with higher death rates regarding treatment success (OR 1.08; 95% CI 1.01 - 1.17, p = 0.03). Statistically significant higher mortality was found among HIV-positive pts on ART (OR 9.93; 95% CI 1.36 - 72.37, p = 0.03) and HIV-positive pts not on ART (OR 397.00; 95% CI 44.27 to 3559.91, p ≤ 0.0001) compared to HIV-negative pts. When multivariate analyses were restricted to HIV-positive pts, being not on ART was associated with higher mortality (OR 40.0; 95% CI 4.37 - 365.78, p = 0.001). Conclusions: There was significant difference in death rates between HIV-positive and HIV-negative TB pts. HIV-positive pts not on ART had a significantly higher mortality.