HIV-Associated Tuberculosis in Russia: Results of the Retrospective Cohort Study over the Period of Two Years

Abstract

Objective: The goal of the work was to study the socio-demographic and clinical profile of the patients with TB/ HIV co-infection, as well as the treatment effectiveness to understand what shortcomings in the work of TB and HIV services are needed to be corrected. Materials and methods: A retrospective study was performed among 377 patients with dual co-infection TB/HIV between January 2015 and December 2016. TB diagnoses were based on clinical symptoms, sputum microscopy, and radiological analyses. The patients were diagnosed as HIV seropositive by ELISA and by Western blot. Results: Out of 377 individuals with co-infection HIV/TB there were 56.8% of patients with newly diagnosed TB. About 30.8% of individuals with newly diagnosed TB did not know they were HIV-positive and attended the hospital for TB treatment. It was revealed that the most predominant TB-form was disseminated pulmonary tuberculosis in the phase of infiltration/decay both among newly diagnosed HIV positive patients and the HIV/ TB patients registered in specialized care centers-50.5% and 49.7%, respectively. The active TB-form (MbT+) accounted for 40.3%. Cavities in the lungs were revealed in 19.9% of patients. The treatment effectiveness cessation of the Mycobacterium tuberculosis allocation was 75.2% in newly diagnosed TB patients and 55.3% in registered patients. Cavity closure had occurred in 54.1% in patients with newly diagnosed TB and 34.2% in registered patients. Only half of the patients (51.1%) constantly took prescribed medications. Conclusion: The high rate of HIV-infected patients with newly diagnosed TB (56.8%) indicates insufficient effectiveness of programmes for early TB testing. Also, the fact that about 30.8% of individuals with newly diagnosed TB were not aware of their HIV positive status indicates the urgent necessity for optimizing the interaction between TB and HIV services. One should also pay attention to the low patients’ adherence to the treatment as only 47.5% of patients did undergo treatment.