Abstract
Poor human immunodeficiency virus (HIV) testing practices and underreporting of HIV-related data in TB information systems remain barriers to effective care for TB-HIV co-infected patients. HIV testing and recording practices in national TB program have not been formally evaluated in Armenia. This study aimed to assess the recording completeness of HIV testing and HIV status in the national TB program electronic database, and to determine trend in HIV testing and the association between HIV testing and treatment outcomes for all TB patients registered in Armenia (2015-2019). A cohort study of TB patients using routine programmatic data from the national TB program of Armenia. From 2015 to 2019, the electronic database was completed for HIV testing and HIV status by 48.1% and 97.5%, respectively. Of all registered TB patients 93.6% were tested for HIV. Of a total 4,674 patients, 1,085 (23.2%) had unsuccessful outcomes. Patients with HIV status "not tested" and "not recorded" compared to HIV "negatives" had 1.76 (95%CI 1.42-2.11) and 1.6 (95%CI 1.20-2.06) times higher risk of unsuccessful outcomes, respectively. Lost to follow-up was the most frequent unsuccessful outcome in HIV status "not tested" group. An analysis of nationwide data revealed incompleteness of the national TB electronic database for HIV data. Patients with HIV status "not tested" and "not recorded" had higher risk of unsuccessful TB treatment outcomes. Upgrade of the electronic database with information on key indicators of TB-HIV services will facilitate improved monitoring and reporting.
Highlights
Poor human immunodeficiency virus (HIV) testing practices and underreporting of HIV-related data in TB information systems remain barriers to effective care for TB-HIV co-infected patients
HIV detection rate among TB patients can be affected by testing practices, such as lack of universal HIV testing and test result reporting for TB patients [9,10]
The management, financing, monitoring and evaluation, coordination of international programs, and other activities related to TB and HIV care are under the responsibility of the Ministry of Health of Armenia through the National TB Control Center (NTCC) and National Center for AIDS Prevention (NCAP) [23,25]
Summary
Poor human immunodeficiency virus (HIV) testing practices and underreporting of HIV-related data in TB information systems remain barriers to effective care for TB-HIV co-infected patients. This study aimed to assess the recording completeness of HIV testing and HIV status in the national TB program electronic database, and to determine trend in HIV testing and the association between HIV testing and treatment outcomes for all TB patients registered in Armenia (2015-2019). Patients with HIV status “not tested” and “not recorded” had higher risk of unsuccessful TB treatment outcomes. Detection and treatment of HIV infection in TB patients is key to improved TB treatment outcomes and reduced mortality in this group [8]. TB patients may refuse HIV testing [9, 10], which is associated with higher risk of unfavorable treatment outcomes [11,12]. Implementation of Abrahamyan et al – HIV testing and TB treatment outcomes
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