Risk Factors for Unfavorable Treatment Outcomes among the Human Immunodeficiency Virus-Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017

Sherali Massavirov, Kristina Akopyan, Fazlkhan Abdugapparov, Ana Ciobanu, Arax Hovhanessyan, Mavluda Khodjaeva, Jamshid Gadoev and Nargiza Parpieva
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Sherali Massavirov: Department of Phthisiology and Pulmonology of the Tashkent Medical Academy, Tashkent 100109, Uzbekistan
Kristina Akopyan: WHO Regional Office for Europe, DK-2100 Copenhagen, Denmark
Fazlkhan Abdugapparov: Department of Phthisiology and Pulmonology of the Tashkent Medical Academy, Tashkent 100109, Uzbekistan
Ana Ciobanu: WHO Regional Office for Europe, DK-2100 Copenhagen, Denmark
Arax Hovhanessyan: WHO Regional Office for Europe, DK-2100 Copenhagen, Denmark
Mavluda Khodjaeva: Department of Phthisiology and Pulmonology of the Tashkent Medical Academy, Tashkent 100109, Uzbekistan
Jamshid Gadoev: World Health Organization Country Office in Uzbekistan, 16, Tarobiy Street, Tashkent 100100, Uzbekistan
Nargiza Parpieva: Department of Phthisiology and Pulmonology of the Tashkent Medical Academy, Tashkent 100109, Uzbekistan

IJERPH, 2021, vol. 18, issue 9, 1-11

Abstract: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management.

Keywords: tuberculosis; treatment outcomes; HIV; opportunistic infection; diabetes; hepatitis C; Uzbekistan; central Asia; operational research; SORT IT (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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