Incidence of active tuberculosis and risk factors for HIV patients infected with HIV at the start of antiretroviral treatment in Luanda 2016-2017

  • Viral hepatitis and HIV
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Background:
In 2017, an estimated 920 000 people living with HIV (PLHIV) have fallen ill with Tuberculosis (TB) worldwide. Angola is one of 20 countries with the highest estimated numbers of incident TB cases among PLHIV. The objective of this study was to assess the incidence and risk factors for active TB among HIV patients during the first 12 months of initial antiretroviral therapy (ART) in a tertiary HIV specialized hospital in Luanda, Angola.
Methods:
A cohort study with a 1-year follow-up period was conducted among 267 HIV patients who started ART and who had a negative screening for active TB in 2016. The outcome was the development of active TB during the follow-up period. Semi-structured questionnaires and review of clinical files were used for data collection. Significance level was set at p<0.05 for all hypothesis tests. Pearson chi-squared (χ2) tests, followed by multivariable logistic regression modelling were used to identify factors associated with active TB.
Results:
The incidence of active tuberculosis was 12.0% (32 patients out of the 267 followed during the 12-months period), from which 59.4% (19) were between 30-49 years old and 65.6% (21) were female. From those 32 patients, 75% (24) developed pulmonary tuberculosis, whereas the remaining developed other forms of active TB. Independent associated factors for active TB were: viral load higher than 10,000 copies [OR = 16.8; 95% CI: 1.7-70; p <0.001]; and having less than 2 meals per day [OR = 17.2; 95%: 2.1-40; p <0.01].
Conclusion
The high incidence of tuberculosis in HIV patients makes it urgent to implement strategies that lead to timely identi- fication, treatment, prophylaxis and prevention of TB among HIV patients on ART. Our study reinforces the Results: of other colleagues in Angola that clearly show the urgent need for stringent Isoniazide prophylactic therapy policy implementation and increased coverage among HIV patients with a negative TB screening.

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