CO-TRIMOXAZOLE PREVENTIVE THERAPY REDUCES ACTIVE PULMONARY TUBERCULOSIS RISK IN PEOPLE LIVING WITH HIV/AIDS ON ANTIRETROVIRAL AT WANGAYA HOSPITAL IN DENPASAR, BALI, INDONESIA: A PROSPECTIVE COHORT STUDY

Abstract

Objective: To evaluate whether co-trimoxazole preventive therapy (CPT) and other contributing factors, among people living with HIV/AIDS (PLWHA) on antiretroviral (ARV) are effective to reduce active pulmonary tuberculosis (APT) at Wangaya Hospital, Denpasar, Bali, Indonesia.
 Methodology: A prospective cohort study was conducted to evaluate the use of CPT in reducing APT. In this study, 403 PLWHA on ARV 151 participants accepted CPT as the first group and 252 PLWHA refused CPT as the second group. Eight participants among the first group and 48 participants among the second group were confirmed APT. Revisits were scheduled every a month to replenish pills and to confirm APT. The CPT effectiveness, sociodemography and laboratory, and reducing APT risk after prospective cohort entry were analyzed using Chi-square with significant p<0.05. Statistical software package SPSS 15.0 was used for statistical analysis.
 Results: Two hundred fifty-one (62.2%) of the participants were males and 152 (37.8%) females. Eight (2.0%) of the first group were confirmed APT and 48 (12.0%) of the second group were confirmed APT (p=0.004). In bivariate analysis (Chi-square), we found that sex (p=0.019), smoking (p=0.000), alcohol consumption (p=0.000), previous history of tuberculosis (TB) (p=0.000), and CD4 cell counts (<69 cell/μL) (p=0.002) were significant APT risk factors. There was significantly less APT risk among the participants who accepted CPT compared with participants refused CPT (p=0.002).
 Conclusions: This study found that CPT was significantly associated with reduce of APT risk in PLWHA. Furthermore, there were significantly added the preventive effect of CPT; sex, smoking, alcohol consumption, previous history of TB, and CD4 cell counts.