Abstract

Objective: Tuberculosis (TB) is the most important opportunistic infection and one of the leading causes of death in individuals living with human immunodeficiency virus (HIV).  Treatment of HIV/TB coinfected patients is more complicated than that of individuals living with HIV only. We aimed to determine the epidemiological characteristics of HIV/TB coinfected patients and the factors affecting TB treatment success.

Methods: This retrospective study was conducted between January 2006 and December 2022. Among individuals living with HIV, those aged ≥18 years and with active tuberculosis were included in the study. Sociodemographic, clinical and laboratory findings of HIV/TB coinfected patients were recorded from their files. Patients were divided into two groups according to TB treatment response. The statistical significance level was accepted as p <0.05 in comparison of the two groups.

Results: Active TB disease was detected in 78 (%8.4) of 931 individuals living with HIV. A total of 74 patients were included in the study. The average age of the patients was 42.84±12.91 years (range 20-78); 64 (86.5%) were male, and 32 (43.2%) were unemployed. Before TB treatment, 36 (48.6%) of the individuals living with HIV had CD4⁺ <100 cells/mm³, 10 (13.5%) had negative viral load and only 12 (16.2%) had received antiretroviral treatment (ART). Of these patients, 42 (56.8%) were evaluated as pulmonary TB and 32 (43.2%) as extrapulmonary TB. TB treatment was successful in 49 (%66.2) of the patients; 15 (%20.3) died, 5 (%6.8) received insufficient treatment, 2 (%2.7) were lost to follow-up, and 3 (%4.1) were transferred to another centre. Unsuccessful TB treatment outcomes were associated with a higher mortality rate (20.3%) and increasing age (p<0.05).

Conclusion: In our study, the success rate of TB treatment in HIV/TB coinfected individuals was determined as 66.2%. Our findings were lower than World Health Organization targets. The high mortality rate and the advancing age of the patients were determined to be the most critical factors affecting the success of the TB treatment. We conclude that more attention should be paid to HIV/TB coinfected patients, strategies should be developed to ensure early diagnosis, and more comprehensive and prospective studies on this subject need to be conducted in our country.