Tuberculosis and human immunodeficiency virus co-infections and their predictors at a hospital-based HIV/AIDS clinic in Uganda

D Nakanjako, H Mayanja-Kizza, J Ouma, R Wanyenze, D Mwesigire, A Namale, J Ssempiira, J Senkusu, R Colebunders, MR Kamya

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    SETTING: Mulago Hospital, Uganda. OBJECTIVE: To evaluate the burden of TB-HIV (tuberculosis-human immunodeficiency virus) co-infections and their predictors in an urban hospital-based HIV programme. DESIGN: Prospective observational study. METHODS: Clinicians screened all patients with HIV/AIDS (acquired immune-deficiency syndrome) for previous and current TB treatment at enrolment and throughout follow-up. RESULTS: Of 10 924 patients enrolled between August 2005 and February 2009, co-prevalent TB was 157/10 924 (1.4%), which included 88/157 (56%) with TB confirmed at enrolment and 65/157 (41%) with TB diagnoses established during follow-up in whom symptoms were present at enrolment. Male sex (adjusted odds ratio [aOR] 2.3, 95%CI 1.6-3.2) and body mass index (BMI) </=20 kg/m(2) (aOR 3.8, 95%CI 2.5-5.4) were associated with co-prevalent TB. Overall, 749/10 767 (7%) were diagnosed with incident TB at a higher rate among antiretroviral treatment (ART) patients (8/100 patient years of observation [PYO]) than non-ART patients (5/100 PYO, log rank P < 0.001). Female sex (adjusted hazard ratio [aHR] 1.4, 95%CI 1.2-1.7) and baseline BMI </= 20 (aHR 1.9, 95%CI 1.6-2.2) predicted incident TB. CONCLUSION: Routine TB screening in the HIV/AIDS care programme identified a significant number of TB-HIV co-infections among patients with and without ART, and is therefore a potential strategy to improve HIV treatment outcomes in resource-limited settings.
    Original languageEnglish
    JournalInternational Journal of Tuberculosis and Lung Disease
    Volume14
    Issue number12
    Pages (from-to)1621-1628
    Number of pages8
    ISSN1027-3719
    Publication statusPublished - 2010

    Keywords

    • B780-tropical-medicine
    • Bacterial diseases
    • Tuberculosis
    • Mycobacterium tuberculosis
    • Co-infections
    • Viral diseases
    • HIV
    • AIDS
    • Disease burden
    • Evaluation
    • Routine
    • Screening
    • Algorithms
    • Predictors
    • Associations
    • Gender
    • Body mass index
    • BMI
    • Control strategies
    • Uganda
    • Africa-East

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