Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out
Juan Ignacio García, Edson Mambuque, Dinis Nguenha, Faustino Vilanculo, Charfudin Sacoor, Guillermo Sequera, Manuel Fernández-Quevedo, Maxime Leroux-La Pierre, Hélio Chiconela, Luis A. Faife, Durval Respeito, Belén Saavedra, Tacilta Nhampossa, Elisa López‐Varela, Alberto L. García‐Basteiro
Abstract
Tuberculosis (TB) misdiagnosis remains a public health concern, especially among people living with HIV (PLHIV), given the high mortality associated with missed TB diagnoses. The main objective of this study was to describe the all-cause mortality, TB incidence rates and their associated risk factors in a cohort of PLHIV with presumptive TB in whom TB was initially ruled out. We retrospectively followed a cohort of PLHIV with presumptive TB over a 2 year-period in a rural district in Southern Mozambique. During the study period 382 PLHIV were followed-up. Mortality rate was 6.8/100 person-years (PYs) (95% CI 5.2-9.2) and TB incidence rate was 5.4/100 PYs (95% CI 3.9-7.5). Thirty-six percent of deaths and 43% of TB incident cases occurred in the first 12 months of the follow up. Mortality and TB incidence rates in the 2-year period after TB was initially ruled out was very high. The TB diagnostic work-up and linkage to HIV care should be strengthened to decrease TB burden and all-cause mortality among PLHIV with presumptive TB.