The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study

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dc.contributor.authorNglazi, Mweete D
dc.contributor.authorBekker, Linda‐Gail
dc.contributor.authorWood, Robin
dc.contributor.authorKaplan, Richard
dc.date.accessioned2021-10-08T06:20:26Z
dc.date.available2021-10-08T06:20:26Z
dc.date.issued2015
dc.description.abstractBackgroundThe implementation of collaborative TB-HIV services is challenging. We, therefore, assessed TB treatment outcomes in relation to HIV infection and antiretroviral therapy (ART) among TB patients attending a primary care service with co-located ART and TB clinics in Cape Town, South Africa.MethodsIn this retrospective cohort study, all new TB patients aged ≥ 15years who registered and initiated TB treatment between 1 October 2009 and 30 June 2011 were identified from an electronic database. The effects of HIV-infection and ART on TB treatment outcomes were analysed using a multinomial logistic regression model, in which treatment success was the reference outcome.ResultsThe 797 new TB patients included in the analysis were categorized as follows: HIV- negative, in 325 patients (40.8%); HIV-positive on ART, in 339 patients (42.5%) and HIV-positive not on ART, in 133 patients (16.7%). Overall, bivariate analyses showed no significant difference in death and default rates between HIV-positive TB patients on ART and HIV-negative patients. Statistically significant higher mortality rates were found among HIV-positive patients not on ART compared to HIV-negative patients (unadjusted odds ratio (OR) 3.25; 95% confidence interval (CI) 1.53–6.91). When multivariate analyses were conducted, the only significant difference between the patient categories on TB treatment outcomes was that HIV-positive TB patients not on ART had significantly higher mortality rates than HIV-negative patients (adjusted OR 4.12; 95% CI 1.76–9.66). Among HIV-positive TB patients (n = 472), 28.2% deemed eligible did not initiate ART in spite of the co-location of TB and ART services. When multivariate analyses were restricted to HIV-positive patients in the cohort, we found that being HIV-positive not on ART was associated with higher mortality (adjusted OR 7.12; 95% CI 2.95–18.47) and higher default rates (adjusted OR 2.27; 95% CI 1.15–4.47).ConclusionsThere was no significant difference in death and default rates between HIV-positive TB patients on ART and HIV negative TB patients. Despite the co-location of services 28.2% of 472 HIV-positive TB patients deemed eligible did not initiate ART. These patients had a significantly higher death and default rates.
dc.identifier.apacitationNglazi, M. D., , Wood, R., & Kaplan, R. (2015). The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study. <i>BMC Infectious Diseases</i>, 15(1), 174 - 177. http://hdl.handle.net/11427/34279en_ZA
dc.identifier.chicagocitationNglazi, Mweete D, , Robin Wood, and Richard Kaplan "The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study." <i>BMC Infectious Diseases</i> 15, 1. (2015): 174 - 177. http://hdl.handle.net/11427/34279en_ZA
dc.identifier.citationNglazi, M.D., , Wood, R. & Kaplan, R. 2015. The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study. <i>BMC Infectious Diseases.</i> 15(1):174 - 177. http://hdl.handle.net/11427/34279en_ZA
dc.identifier.issn1471-2334
dc.identifier.ris TY - Journal Article AU - Nglazi, Mweete D AU - Bekker, Linda‐Gail AU - Wood, Robin AU - Kaplan, Richard AB - BackgroundThe implementation of collaborative TB-HIV services is challenging. We, therefore, assessed TB treatment outcomes in relation to HIV infection and antiretroviral therapy (ART) among TB patients attending a primary care service with co-located ART and TB clinics in Cape Town, South Africa.MethodsIn this retrospective cohort study, all new TB patients aged ≥ 15years who registered and initiated TB treatment between 1 October 2009 and 30 June 2011 were identified from an electronic database. The effects of HIV-infection and ART on TB treatment outcomes were analysed using a multinomial logistic regression model, in which treatment success was the reference outcome.ResultsThe 797 new TB patients included in the analysis were categorized as follows: HIV- negative, in 325 patients (40.8%); HIV-positive on ART, in 339 patients (42.5%) and HIV-positive not on ART, in 133 patients (16.7%). Overall, bivariate analyses showed no significant difference in death and default rates between HIV-positive TB patients on ART and HIV-negative patients. Statistically significant higher mortality rates were found among HIV-positive patients not on ART compared to HIV-negative patients (unadjusted odds ratio (OR) 3.25; 95% confidence interval (CI) 1.53–6.91). When multivariate analyses were conducted, the only significant difference between the patient categories on TB treatment outcomes was that HIV-positive TB patients not on ART had significantly higher mortality rates than HIV-negative patients (adjusted OR 4.12; 95% CI 1.76–9.66). Among HIV-positive TB patients (n = 472), 28.2% deemed eligible did not initiate ART in spite of the co-location of TB and ART services. When multivariate analyses were restricted to HIV-positive patients in the cohort, we found that being HIV-positive not on ART was associated with higher mortality (adjusted OR 7.12; 95% CI 2.95–18.47) and higher default rates (adjusted OR 2.27; 95% CI 1.15–4.47).ConclusionsThere was no significant difference in death and default rates between HIV-positive TB patients on ART and HIV negative TB patients. Despite the co-location of services 28.2% of 472 HIV-positive TB patients deemed eligible did not initiate ART. These patients had a significantly higher death and default rates. DA - 2015 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PY - 2015 SM - 1471-2334 T1 - The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study TI - The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study UR - http://hdl.handle.net/11427/34279 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34279
dc.identifier.vancouvercitationNglazi MD, , Wood R, Kaplan R. The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study. BMC Infectious Diseases. 2015;15(1):174 - 177. http://hdl.handle.net/11427/34279.en_ZA
dc.language.isoeng
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Infectious Diseases
dc.source.journalissue1
dc.source.journalvolume15
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12879-015-1275-3
dc.subject.otherAdult
dc.subject.otherAnti-Retroviral Agents
dc.subject.otherAntitubercular Agents
dc.subject.otherCohort Studies
dc.subject.otherCommunity Health Services
dc.subject.otherFemale
dc.subject.otherHIV Infections
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMiddle Aged
dc.subject.otherPrimary Health Care
dc.subject.otherPrognosis
dc.subject.otherRetrospective Studies
dc.subject.otherSouth Africa
dc.subject.otherTreatment Outcome
dc.titleThe impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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