Incidence and Predictors of Tuberculosis Among Adults Living With HIV/AIDS on Antiretroviral Therapy in Central Gondar Zone, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study
TL;DR
Tuberculosis incidence was relatively low, while isoniazid use was protective, and poor adherence, opportunistic infections, and large family size increased risk, while isoniazid use was protective.
Abstract
Background Tuberculosis is a major communicable disease and the leading cause of death among people living with HIV/AIDS, accounting for nearly 40% of AIDS-related deaths. This study assessed the incidence and predictors of tuberculosis among adults receiving antiretroviral therapy in Central Gondar Zone, Northwest Ethiopia, from December 2016 to January 2022. Methods A multicenter retrospective follow-up study was conducted among 488 adult HIV-positive individuals on antiretroviral therapy. Data were collected using an Android-based mobile application and analyzed using a Cox proportional hazards model. Variables with p < 0.05 were considered significant predictors. Results The tuberculosis incidence rate was 2.87 per 100 person-years (95% CI: 2.22–3.70). Increased risk was associated with opportunistic infections (Adjusted Hazard Ratio (AHR)=3.16), poor antiretroviral therapy (ART) adherence (Adjusted Hazard Ratio (AHR)=3.53), and family size ≥5 (AHR=2.36). Isoniazid preventive therapy (IPT) reduced tuberculosis risk (AHR≈0.26–0.29). Conclusion Tuberculosis incidence was relatively low. Poor adherence, opportunistic infections, and large family size increased risk, while isoniazid use was protective.