Exploring HIV disease indicators at MDR-TB treatment initiation in South Africa

Author:

Geiger K.1,Patil A.2,Bergman A.1,Budhathoki C.1,Heidari O.2,Lowensen K.2,Mthimkhulu N.,McNabb K.C.1,Mmed N.N.3,Ngozo J.4,Reynolds N.1,Farley J.E.1

Affiliation:

1. Johns Hopkins University School of Nursing, Baltimore, MD, USA

2. Johns Hopkins Center for Infectious Disease and Nursing Innovation, Baltimore, MD, USA

3. National Department of Health, TB Control and Management, Pretoria, South Africa

4. KwaZulu Natal Department of Health, Pietermaritzburg, South Africa

Abstract

BACKGROUND: Understanding relationships between HIV and multidrug-resistant TB (MDR-TB) is crucial for ensuring successful MDR-TB outcomes.METHODS: We used a cross-sectional analysis to evaluate sociodemographic and clinical characteristics as correlates of antiretroviral therapy (ART) use, having an HIV viral load (VL) result, and HIV viral suppression in a cross-sectional sample of people with HIV (PWH) and MDR-TB enrolled in a cluster-randomized trial of nurse case management to improve MDR-TB outcomes.RESULTS: Among 1,479 PWH, the mean age was 37.1 years; 809 (54.7%) were male, and 881 (59.6%) were taking ART. Housing location, employment status, and CD4 count differed significantly between those taking vs. those not taking ART. Among the 881 taking ART, 681 (77.3%) had available HIV VL results. Housing location, CD4 count, and prior history of TB differed significantly between those with and without a VL result. Among the 681 with a VL result, 418 (61.4%) were virally suppressed. Age, education level, CD4 count, TB history, housing location, and ART type differed significantly between those with and without viral suppression.CONCLUSION: PWH presenting for MDR-TB treatment with a history of TB, taking a protease inhibitor, or living in a township may risk poor MDR-TB outcomes.

Publisher

International Union Against Tuberculosis and Lung Disease

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