Jornal de AIDS e Pesquisa Clínica

Mortality of Adults on Antiretroviral Therapy with and without TB coinfection in Jimma University Hospital, Ethiopia: Retrospective Cohort Study

Abstract

Jimma Likisa Lenjisa, Sultan Suleman Wega, Tefera Belachew Lema and Gemeda Abebe Ayana

Background: In this study, it was hypothesized that tuberculosis co-infection independently increases the risk of mortality in people living with HIV (PLWHs) even if they are on antiretroviral therapy (ART). Therefore, investigating this hypothesis among cohort of adult PLWHs in south west Ethiopia was the aim of the present work.

Methods: A cohort study was conducted from December to August 2012 at Jimma University Specialized Hospital (JUSH). PLWHs initiating ART between 2008 and 2011 were included using simple random sampling. The effect of TB co-infection on all-cause mortality was assessed using Cox proportional hazard model.

Results: In crude analysis, all-cause mortality of TB co-infected patients was higher by 6.5% (P=0.004). However, multivariate analysis showed that TB co-infection didn’t increase mortality (AHR, 1.31(0.573-3.007), P=0.52). Instead, factors which increased death were low baseline functional status, malnutrition, CD4 count <100cells/mm3 at the initiation of ART.

Conclusion: In this study, it was shown that TB co-infection didn’t independently increase mortality provided that patient is on ART. Therefore, beside TB, addressing patient’s nutritional status and intervention to facilitate early presentation to health facilities before they deteriorate functionally and immunologically is mandatory to reduce mortality on ART.