Incidence and Predictors of Tuberculosis Among Adults Living With HIV/AIDS on Antiretroviral Therapy in Central Gondar Zone, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study.

BackgroundTuberculosis is a major communicable disease and the leading cause of death among people living with HIV/AIDS, accounting for nearly 40% of AIDS-related deaths. This study assessed the incidence and predictors of tuberculosis among adults receiving antiretroviral therapy in Central Gondar Zone, Northwest Ethiopia, from December 2016 to January 2022.MethodsA multicenter retrospective follow-up study was conducted among 488 adult HIV-positive individuals on antiretroviral therapy. Data were collected using an Android-based mobile application and analyzed using a Cox proportional hazards model. Variables with p < 0.05 were considered significant predictors.ResultsThe tuberculosis incidence rate was 2.87 per 100 person-years (95% CI: 2.22-3.70). Increased risk was associated with opportunistic infections (Adjusted Hazard Ratio (AHR)=3.16), poor antiretroviral therapy (ART) adherence (Adjusted Hazard Ratio (AHR)=3.53), and family size ≥5 (AHR=2.36). Isoniazid preventive therapy (IPT) reduced tuberculosis risk (AHR≈0.26-0.29).ConclusionTuberculosis incidence was relatively low. Poor adherence, opportunistic infections, and large family size increased risk, while isoniazid use was protective.