Outcomes and complications of hospitalised patients with HIV‐TB co‐infection

• Published in: Tropical medicine & international health 2021-01, Vol.26 (1), p.82-88
• Main Authors: Agudelo, Carlos Andrés, Álvarez, María Fernanda, Hidrón, Alicia, Villa, Juan Pablo, Echeverri‐Toro, Lina María, Ocampo, Adriana, Porras, Glenys Patricia, Trompa, Iván Mauricio, Restrepo, Laura, Eusse, Alejandro, Restrepo, Carlos Andrés
• Format: Article
• Language: English
• Subjects: Antiretroviral agents; Antiretroviral therapy; CD4 antigen; co‐infection HIV/TB; Diagnosis; Diagnostic systems; Drug therapy; drug toxicity; HIV; Hospitals; Human immunodeficiency virus; latent tuberculosis; Lymphocytes; Lymphocytes T; Mortality; Patients; Public health; readmission; Skin tests; Therapy; Toxicity; Tuberculin; Tuberculosis
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13509

Background Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co‐infection have rarely been described since antiretroviral therapy became widely available. Methods Prospective cohort study of HIV‐infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015. Results Among 128 HIV‐infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T‐cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%. Conclusions Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV‐infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities. ContexteLa tuberculose (TB) est l'une des causes les plus courantes d'hospitalisation chez les patients VIH positifs. Malgré cela, les résultats hospitaliers des patients atteints de cette coinfection ont rarement été décrits depuis que le traitement antirétroviral est devenu largement disponible.MéthodesEtude de cohorte prospective de patients adultes infectés par le VIH hospitalisés pour TB dans six hôpitaux de référence à Medellin, en Colombie, d'août 2014 à juillet 2015.RésultatsSur 128 patients infectés par le VIH hospitalisés pour TB, l'âge moyen était de 38,4 ans; 79,7% étaient des hommes. Le VIH a été diagnostiqué à l'admission chez 28,9% des patients. Le nombre médian de lymphocytes T CD4+ était de 125 (±158 SD) cellules/µL. Seuls 47,3% des patients dont le diagnostic de VIH était connu lors de leur admission étaient sous traitement antirétroviral et 11,1% seulement avaient subi un test cutané à la tuberculine l'année précédente. Une toxicité médicamenteuse due aux médicaments antituberculeux est survenue chez 11,7% des patients. La durée moyenne de séjour était de 23,2 jour