Journal of clinical practice and research · 2024
Clinical Characteristics of Tuberculosis Among People Living with Human Immunodeficiency Virus (HIV): A Multicenter Study.
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Balık Recep, Karacaer Zehra, Akça Veysel, Kaya Bülent, Akbulut İlkay, Öz Esra Duru, Kuzi Semanur, Eser Fatma, Tahmaz Alper, Kömür Süheyla, İnal Ayşe Seza, Karaoğlan İlkay, Mete Ayşe Özlem, Şenbayrak Seniha, Günal Özgür, Topal Şeyma, Çakırca Tuba Damar, Akbulut Ayhan, Kaygusuz Türkan, Aydın Özlem, Ergen Pınar, Caşkurlu Hülya, Tuna Nazan, Çabalak Mehmet, Kurtaran Behice
Аннотация
OBJECTIVE: The intersection of human immunodeficiency virus (HIV) and tuberculosis (TB) presents a significant public health challenge, particularly in regions with high prevalence of both diseases. This multicenter, retrospective study aimed to evaluate the clinical characteristics, treatment outcomes, and factors influencing the development of TB in individuals infected with HIV.
MATERIALS AND METHODS: This multicenter, retrospective study included individuals infected with HIV from 15 centers, assessing demographic and disease-related data. Inclusion criteria encompassed HIV patients over 18 years of age with TB treatment histories. Data analysis utilized SPSS Statistics version 25.0, adhering to the ethical principles of the Declaration of Helsinki.
RESULTS: The study included 9,720 HIV-infected patients from 15 centers, with TB detected in 124 (1.28%) of these individuals. The majority were male, and the median age at TB diagnosis was 43 years. Clinical findings revealed that pulmonary TB was the most common form (69.4%), with weight loss, cough, and fever as prevalent symptoms. The study also noted a significant delay in TB diagnosis, with a median symptom duration of 60 days. Only six patients exhibited resistance to TB medications. The most commonly used antiretroviral treatment regimen was tenofovir disoproxil fumarate/emtricitabine/dolutegravir (TDF/FTC/DTG). Immune reconstitution inflammatory syndrome (IRIS) developed in 12.1% of patients. Despite these challenges, 79.8% of patients successfully completed TB treatment. However, mortality was observed in 11.3% of cases.
CONCLUSION: The study highlighted the need for improved screening and prophylaxis for latent TB in individuals infected with HIV, especially those with low CD4+ T lymphocyte counts. The results underscore the importance of timely diagnosis and careful management of HIV-TB co-infection to reduce morbidity and mortality.
MATERIALS AND METHODS: This multicenter, retrospective study included individuals infected with HIV from 15 centers, assessing demographic and disease-related data. Inclusion criteria encompassed HIV patients over 18 years of age with TB treatment histories. Data analysis utilized SPSS Statistics version 25.0, adhering to the ethical principles of the Declaration of Helsinki.
RESULTS: The study included 9,720 HIV-infected patients from 15 centers, with TB detected in 124 (1.28%) of these individuals. The majority were male, and the median age at TB diagnosis was 43 years. Clinical findings revealed that pulmonary TB was the most common form (69.4%), with weight loss, cough, and fever as prevalent symptoms. The study also noted a significant delay in TB diagnosis, with a median symptom duration of 60 days. Only six patients exhibited resistance to TB medications. The most commonly used antiretroviral treatment regimen was tenofovir disoproxil fumarate/emtricitabine/dolutegravir (TDF/FTC/DTG). Immune reconstitution inflammatory syndrome (IRIS) developed in 12.1% of patients. Despite these challenges, 79.8% of patients successfully completed TB treatment. However, mortality was observed in 11.3% of cases.
CONCLUSION: The study highlighted the need for improved screening and prophylaxis for latent TB in individuals infected with HIV, especially those with low CD4+ T lymphocyte counts. The results underscore the importance of timely diagnosis and careful management of HIV-TB co-infection to reduce morbidity and mortality.