Abstract
The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied. To assess the TB incidence in HIV-infected adults and its associated risk factors. A cohort study with retrospective review of medical records and prospective follow-up of HIV-infected adult participants attending CTC who were 18-55 years old, had CD4 count more than 250 cells/mm3 in the period of 2008-2010 and were not on ART at enrolment. Cox proportional hazard regression was used to explore the predictors of incident TB. Overall 777 (24%) of 3,279 CTC enrolled HIV-infected adults fulfilled the inclusion criteria of the study. The incidence of TB in the study population ranged from 0.8/100 per person years (PY) at risk (95% CI 0.5-1.3) in the main analysis to 1.7/100 PY at risk (95% CI 1.0-2.6) in sensitivity analyses. Only prior history of TB disease was found to have a significant association with an increased risk of TB, hazard ratio 5.7 (95% CI 2.0-16.4, p value 0.001). Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Previously TB treated patients have a much higher risk of getting TB again than those who never had TB before.
Highlights
Previous studies on HIV and Tuberculosis co-infection reported varying TB incidences among HIV-infected population in high burden countries
Risk factor analysis for TB included age, gender, World Health Organization (WHO) clinical stage, CD4 cell count at enrollment (250-350 and >350 cells/mm3), previous history of TB documented and ART start during follow-up were considered based on clinical relevance and availability
The TB incidence was 0.8/100 person years (PY) at risk; and was higher with different sensitivity analyses. This tendency is due to fewer persons and less follow-up time being included compared to the main analysis
Summary
Previous studies on HIV and Tuberculosis co-infection reported varying TB incidences among HIV-infected population in high burden countries. The specific objectives of this study were to measure the incidence of TB and its associated risk factors. This type of studies is rarely done and this information is useful to determine TB screening strategies for HIV-infected persons. The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied. Objective: To assess the TB incidence in HIV-infected adults and its associated risk factors. Conclusion: Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Tuberculosis among HIV-infected population: incidence and risk factors in rural Tanzania.
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