Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil

Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Inflamação e Biomarcadores. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brazil / Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brazil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil /Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brazil / Grupo de Estudos em Medicina Intensiva. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Laboratório de Análise e Visualização de Dados. Porto Velho, RO, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Inflamação e Biomarcadores. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander Von Humboldt. Lima, Peru.
Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brazil / Fundação Medicina Tropical Doutor Heitor Vieira Dourado. Manaus, AM, Brazil / Universidade Nilton Lins. Faculdade de Medicina. Manaus, AM, Brazil.
Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Clínica Médica. Rio de Janeiro, RJ, Brazil / Universidade Federal do Rio de Janeiro. Programa Acadêmico de Tuberculose da Faculdade de Medicina. Rio de Janeiro, RJ, Brazil.
Vanderbilt University School of Medicine. Department of Medicine. Division of Infectious Diseases. Nashville, TN, United States.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Inflamação e Biomarcadores. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil /Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brazil / Faculdade de Ciência e Tecnologia. Curso de Medicina. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Inflamação e Biomarcadores. Salvador, BA, Brasil / Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil /Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brazil / Faculdade de Ciência e Tecnologia. Curso de Medicina. Salvador, BA, Brazil / Universidade Salvador. Curso de Medicina. Salvador, BA, Brazil / Vanderbilt University School of Medicine. Department of Medicine. Division of Infectious Diseases. Nashville, TN, United States.

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, p = 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.

Keywords

Antiretroviral therapy (ART)
HIV
Diabetes
Treatment outcome
Tuberculosis

Publisher

Frontiers Media

Citation

VILLALVA-SERRA, Klauss et al. Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil. Frontiers in Medicine, v. 9, p. 1-12, 2022.

DOI

10.3389/fmed.2022.972145

ISSN

2296-858X

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/55604

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Open access

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