Tuberculosis Treatment Outcomes of Diabetic and Non-diabetic TB/HIV Co-infected Patients: A Nationwide Observational Study in Brazil

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Oct 3

PMID 36186793

Authors

Klauss Villalva-Serra

Beatriz Barreto-Duarte

Vanessa M Nunes

Rodrigo C Menezes

Moreno M S Rodrigues

Artur T L Queiroz

Maria B Arriaga

Marcelo Cordeiro-Santos

Afranio L Kritski

Timothy R Sterling

Mariana Araujo-Pereira

Bruno B Andrade

Affiliations

Soon will be listed here.

Abstract

Background: Tuberculosis (TB) is a worldwide public health problem, especially in countries that also report high numbers of people living with HIV (PLWH) and/or diabetes mellitus (DM). However, the unique features of persons with TB-HIV-DM are incompletely understood. This study compared anti-TB treatment (ATT) outcomes of diabetic and non-diabetic TB/HIV co-infected patients.

Methods: A nationwide retrospective observational investigation was performed with data from the Brazilian Tuberculosis Database System among patients reported to have TB-HIV co-infection between 2014 and 2019. This database includes all reported TB cases in Brazil. Exploratory and association analyses compared TB treatment outcomes in DM and non-DM patients. Unfavorable outcomes were defined as death, treatment failure, loss to follow-up or recurrence. Multivariable stepwise logistic regressions were used to identify the variables associated with unfavorable ATT outcomes in the TB-HIV population.

Results: Of the 31,070 TB-HIV patients analyzed, 999 (3.2%) reported having DM. However, in these TB-HIV patients, DM was not associated with any unfavorable treatment outcome [adjusted Odds Ratio (aOR): 0.97, 95% CI: 0.83-1.12, = 0.781]. Furthermore, DM was also not associated with any specific type of unfavorable outcome in this study. In both the TB-HIV group and the TB-HIV-DM subpopulation, use of alcohol, illicit drugs and tobacco, as well as non-white ethnicity and prior TB were all characteristics more frequently observed in persons who experienced an unfavorable ATT outcome.

Conclusion: DM is not associated with unfavorable TB treatment outcomes in persons with TB-HIV, including death, treatment failure, recurrence and loss to follow up. However, consumption habits, non-white ethnicity and prior TB are all more frequently detected in those with unfavorable outcomes in both TB-HIV and TB-HIV-DM patients.

Citing Articles

The impact of diabetes mellitus on tuberculosis recurrence in Eastern China: a retrospective cohort study.

Wang Y, Shi J, Yin X, Tao B, Shi X, Mao X BMC Public Health. 2024; 24(1):2534.

PMID: 39294658 PMC: 11409766. DOI: 10.1186/s12889-024-20019-5.

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