Active TB infection and its associated factors among HIV-1 infected patients at Jimma medical center, Southwest Ethiopia

Temesgen Mulugeta,Belachew Umeta,Alazar Takale,Behailu Terefe

doi:10.1186/s40780-021-00228-5

Temesgen Mulugeta, Belachew Umeta + Show 2 more

Open Access

https://doi.org/10.1186/s40780-021-00228-5

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Abstract

BackgroundHuman immune deficiency virus (HIV) increases the susceptibility to primary infection or reinfection and the risk of tuberculosis (TB) reactivation for patients with latent TB. There was no current report on the rate of active TB infection among HIV-1 infected patients in our teaching and referral hospital. Therefore, this study was aimed to determine the prevalence and factors associated with active TB infection among HIV-1 infected patients.MethodsHospital-based retrospective cross-sectional study was conducted at the Anti-Retroviral Therapy (ART) chronic follow-up clinic. Systematic random sampling was used to include the patients. A structured questionnaire was used to collect data. Data were analyzed using SPSS version 25. Descriptive statistics were used to describe the findings and multivariate logistic regression was performed to identify factors associated with active TB infection.Result150 HIV-1 infected patients (female 54.7%) were included. The median (interquartile range, IQR) age of the patients was 33.5 (25.7, 40.0) years. Twenty-six (17.3%) of the patients had developed active TB infection, which was independently associated with the WHO clinical stage III and IV (AOR: 9.67, 95% confidence interval (CI); 2.21–42.37), p = 0.003). The use of isoniazid preventive therapy (IPT) (AOR: 0.123, 95CI; 0.034–0.44, p = 0.001) and having good adherence to ART medications (AOR: 0.076, 95CI; 0.007–0.80, p = 0.032) was associated with the reduced risk of active TB infection among HIV-1 infected patients.ConclusionsAdvanced WHO clinical stages increased the risk of active TB infection, while the use of IPT and good adherence to ART medications reduced the risk of active TB infection. Therefore, patients with advanced WHO clinical stage should be screened for TB infection, and starting IPT for the candidate patients should be strengthened to reduce the burden of active TB incidence. ART medication adherence should also be supported.

Highlights

In 2015, there were an estimated 10.4 million cases of Tuberculosis (TB) disease globally, including 1.2 million [11%] among people living with the Human immunedeficiency virus (HIV)
In order to reduce the incidence of TB infection in people living with Human immune deficiency virus (HIV) (PLWH), World Health Organization (WHO) recommends the three I’s strategy: intensified case-finding (ICF), isoniazid preventive therapy (IPT), and infection control (IC) at all clinical encounters
Advanced WHO clinical stages increased the risk of developing TB infection

Summary

Introduction

In 2015, there were an estimated 10.4 million cases of Tuberculosis (TB) disease globally, including 1.2 million [11%] among people living with the Human immunedeficiency virus (HIV). Almost 60% of TB cases among people living with HIV (PLWH) were not diagnosed or HIV infection is the most important risk factor for developing active tuberculosis, which increases the susceptibility to primary infection or reinfection and the risk of tuberculosis (TB) reactivation for patients with latent TB. It speeds up the progression of HIV infection to Acquired immunodeficiency syndrome (AIDS). Human immune deficiency virus (HIV) increases the susceptibility to primary infection or reinfection and the risk of tuberculosis (TB) reactivation for patients with latent TB. This study was aimed to determine the prevalence and factors associated with active TB infection among HIV-1 infected patients

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