Predictors of the Occurrence of Tuberculosis in HIV-infected Adults during the First Six Months of Antiretroviral Therapy in Kisangani, DR Congo

Objective: To determine the predictive factors for the occurrence of tuberculosis (TB) in adults infected with the human immunodeficiency virus (HIV) during the first 6 months of antiretroviral therapy (ART) in Kisangani.

Methods: A case-control study was carried out during the period from January 1, 2017 to December 31, 2018. Clinical data were collected retrospectively from patients receiving antiretroviral therapy in the city of Kisangani. Of a total of 1,161 HIV-infected patients included in this study, 58 of them developed TB. The diagnosis of tuberculosis was made on the presence of Acid-Alcohol-Resistant Bacile (BAAR) on at least one biological sample or on the basis of a bundle of clinical and paraclinical arguments. This test is done during the first six months of initiating anti retroviral therapy (ART). Predictive factors for the onset of TB in these patients on antiretroviral therapy were identified using logistic regression analysis.

Results: After multivariate analysis, the independent factors associated with the onset of TB were: being married (OR = 4.456; 95% CI: 1.061-18.713), residence in the town of Tshopo (OR = 7.04; 95% CI: 1.168-42.47) as well as stages 3 and 4 of AIDS disease (OR = 29 95% CI: 4.563-184.872 and OR = 50.8 95% CI: 3.971-680.995).

Conclusion: The results found by this study highlight the need for active TB testing in HIV-infected individuals. Particular emphasis should be placed on the category of patients on antiretroviral therapy who have one of the independent factors for the onset of TB.