Human immunodeficiency virus and tuberculosis coinfection: clinical features and predictors of mortality

Authors: FATMA GÜMÜŞER, MERVE ALTINKAYNAK, DİLEK YILDIZ SEVGİ, ÖZLEM ALTUNTAŞ AYDIN, BİLGÜL METE, ALPER GÜNDÜZ, HAYAT KUMBASAR KARAOSMANOĞLU, SİBEL BOLUKÇU, ÖMER FEHMİ TABAK, MUSTAFA HALUK VAHABOĞLU

Abstract: Background/aim: This study was undertaken to identify subjects with human immunodeficiency virus and tuberculosis (HIV/TB) coinfection in a group of HIV-positive patients followed at five different healthcare centers, and to determine the demographic and clinical characteristics of these subjects as well as the predictors of mortality. Materials and methods: A database search for subjects with TB coinfection was performed among 1475 HIV-positive adult patients and a total of 66 individuals were identified with HIV/TB coinfection. Results: There were 66 patients (4.5%) with TB coinfection. Twenty-one percent (n = 14) of the patients with TB coinfection died during the study period and these patients had significantly lower baseline CD4 counts at the time of TB diagnosis (P = 0.005). None of the patients with CD4 count of ≥200 cells/mm3 died during follow-up and a low CD4 count at the time of TB diagnosis (<200 cells/ mm3) was associated with poor survival (P = 0.012). However, none of the parameters emerged as significant independent predictors of survival in multivariate analysis. Conclusion: Coexistence of TB and HIV infection is associated with many clinical challenges and a better understanding of patient characteristics as well as the parameters impacting the outcome will improve the quality of care provided for this group of patients.

Keywords: Human immunodeficiency virus, tuberculosis, coinfection, mortality

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