Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India
Identifieur interne : 000E49 ( Main/Curation ); précédent : 000E48; suivant : 000E50Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India
Auteurs : Vandana Hiregoudar ; Bellara Raghavendra ; Aravind Karinagannavar ; Wahid Khan ; Sneha Kamble ; Timmalapur G. GoudSource :
- Journal of Family & Community Medicine [ 1319-1683 ] ; 2016.
Abstract
The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic has caused a re-emergence of tuberculosis (TB). In persons infected with both HIV and TB, the lifetime risk of developing TB disease is 50–70% compared to 10% in HIV-negative individuals. India has world's 3rd highest HIV burden and is also one of the countries endemic for TB, so the country faces a dual epidemic of HIV and TB.
To find out the proportion and determinants of TB in HIV-positive subjects.
This study was undertaken at the ART center from June 01, 2012, to May 31, 2013. HIV-positive subjects aged above 15 years who had been on antiretroviral therapy (ART) for more than 6 months were included in the study. Nonprobability purposive sampling was adopted. A predesigned semi-structured questionnaire was used to obtain data.
A total of 536 HIV-positive people were interviewed, 58.8% of whom were males, 79.1% were Hindu, 61.0% had up to high school education, and 57% were unskilled laborers. About 63% were married, 40% were from the upper lower class, and 60% were from urban areas. For the majority (89.1%), the probable mode of transmission of HIV was by the heterosexual route. TB co-infection was present in 38.4% subjects. The most common form of TB was extra-pulmonary in subjects on antituberculous treatment (47.3%) and among old cases (57.6%). On bivariate analysis, 136 (42.4%) married subjects and those from rural areas were more commonly affected by TB compared to subjects who were unmarried and from urban areas with odds ratio (OR): 1.555, confidence interval (CI): 1.077–2.246 and OR: 1.523, CI: 1.061–2.185, respectively. The proportion of TB was high among subjects who lived in overcrowded houses 130 (44.2%), and who had a habit of alcohol use compared to others with OR: 1.731, CI: 1.734–2.179 and OR: 1.524, CI: 1.045–2.223, respectively. Logistic regression analysis showed that TB among people living with HIV/AIDS was highest in persons living in overcrowded houses (OR: 1.706, CI: 1.185–2.458) and those who consumed alcohol (OR: 1.605, CI: 1.090–2.362).
Demographic factors like male gender, middle age, living in the rural areas, consumption of alcohol, and living in overcrowded houses were found with a higher proportion of TB. The use of highly active ART appeared to progressively decrease but did not completely eliminate the risk of TB.
Url:
DOI: 10.4103/2230-8229.181009
PubMed: 27186154
PubMed Central: 4859104
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India</title><author><name sortKey="Hiregoudar, Vandana" sort="Hiregoudar, Vandana" uniqKey="Hiregoudar V" first="Vandana" last="Hiregoudar">Vandana Hiregoudar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Raghavendra, Bellara" sort="Raghavendra, Bellara" uniqKey="Raghavendra B" first="Bellara" last="Raghavendra">Bellara Raghavendra</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Karinagannavar, Aravind" sort="Karinagannavar, Aravind" uniqKey="Karinagannavar A" first="Aravind" last="Karinagannavar">Aravind Karinagannavar</name><affiliation><nlm:aff id="aff3"><italic>Department of Community Medicine, MIMS, Mysore, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Khan, Wahid" sort="Khan, Wahid" uniqKey="Khan W" first="Wahid" last="Khan">Wahid Khan</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Kamble, Sneha" sort="Kamble, Sneha" uniqKey="Kamble S" first="Sneha" last="Kamble">Sneha Kamble</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Goud, Timmalapur G" sort="Goud, Timmalapur G" uniqKey="Goud T" first="Timmalapur G." last="Goud">Timmalapur G. Goud</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27186154</idno><idno type="pmc">4859104</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859104</idno><idno type="RBID">PMC:4859104</idno><idno type="doi">10.4103/2230-8229.181009</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000382</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000382</idno><idno type="wicri:Area/Pmc/Curation">000382</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000382</idno><idno type="wicri:Area/Pmc/Checkpoint">000528</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000528</idno><idno type="wicri:Area/Ncbi/Merge">003783</idno><idno type="wicri:Area/Ncbi/Curation">003783</idno><idno type="wicri:Area/Ncbi/Checkpoint">003783</idno><idno type="wicri:doubleKey">1319-1683:2016:Hiregoudar V:proportion:and:determinants</idno><idno type="wicri:Area/Main/Merge">000E49</idno><idno type="wicri:Area/Main/Curation">000E49</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Proportion and determinants of tuberculosis among human immunodeficiency virus-positive patients attending the antiretroviral therapy center attached to a Medical College in South India</title><author><name sortKey="Hiregoudar, Vandana" sort="Hiregoudar, Vandana" uniqKey="Hiregoudar V" first="Vandana" last="Hiregoudar">Vandana Hiregoudar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Raghavendra, Bellara" sort="Raghavendra, Bellara" uniqKey="Raghavendra B" first="Bellara" last="Raghavendra">Bellara Raghavendra</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Karinagannavar, Aravind" sort="Karinagannavar, Aravind" uniqKey="Karinagannavar A" first="Aravind" last="Karinagannavar">Aravind Karinagannavar</name><affiliation><nlm:aff id="aff3"><italic>Department of Community Medicine, MIMS, Mysore, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Khan, Wahid" sort="Khan, Wahid" uniqKey="Khan W" first="Wahid" last="Khan">Wahid Khan</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Kamble, Sneha" sort="Kamble, Sneha" uniqKey="Kamble S" first="Sneha" last="Kamble">Sneha Kamble</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author><author><name sortKey="Goud, Timmalapur G" sort="Goud, Timmalapur G" uniqKey="Goud T" first="Timmalapur G." last="Goud">Timmalapur G. Goud</name><affiliation><nlm:aff id="aff2"><italic>Department of Community Medicine, VIMS, Bellary, Karnataka, India</italic></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Family & Community Medicine</title><idno type="ISSN">1319-1683</idno><idno type="eISSN">2229-340X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic has caused a re-emergence of tuberculosis (TB). In persons infected with both HIV and TB, the lifetime risk of developing TB disease is 50–70% compared to 10% in HIV-negative individuals. India has world's 3<sup>rd</sup> highest HIV burden and is also one of the countries endemic for TB, so the country faces a dual epidemic of HIV and TB.</p></sec><sec id="st2"><title>Objectives:</title><p>To find out the proportion and determinants of TB in HIV-positive subjects.</p></sec><sec id="st3"><title>Subjects and Methods:</title><p>This study was undertaken at the ART center from June 01, 2012, to May 31, 2013. HIV-positive subjects aged above 15 years who had been on antiretroviral therapy (ART) for more than 6 months were included in the study. Nonprobability purposive sampling was adopted. A predesigned semi-structured questionnaire was used to obtain data.</p></sec><sec id="st4"><title>Results:</title><p>A total of 536 HIV-positive people were interviewed, 58.8% of whom were males, 79.1% were Hindu, 61.0% had up to high school education, and 57% were unskilled laborers. About 63% were married, 40% were from the upper lower class, and 60% were from urban areas. For the majority (89.1%), the probable mode of transmission of HIV was by the heterosexual route. TB co-infection was present in 38.4% subjects. The most common form of TB was extra-pulmonary in subjects on antituberculous treatment (47.3%) and among old cases (57.6%). On bivariate analysis, 136 (42.4%) married subjects and those from rural areas were more commonly affected by TB compared to subjects who were unmarried and from urban areas with odds ratio (OR): 1.555, confidence interval (CI): 1.077–2.246 and OR: 1.523, CI: 1.061–2.185, respectively. The proportion of TB was high among subjects who lived in overcrowded houses 130 (44.2%), and who had a habit of alcohol use compared to others with OR: 1.731, CI: 1.734–2.179 and OR: 1.524, CI: 1.045–2.223, respectively. Logistic regression analysis showed that TB among people living with HIV/AIDS was highest in persons living in overcrowded houses (OR: 1.706, CI: 1.185–2.458) and those who consumed alcohol (OR: 1.605, CI: 1.090–2.362).</p></sec><sec id="st5"><title>Conclusions:</title><p>Demographic factors like male gender, middle age, living in the rural areas, consumption of alcohol, and living in overcrowded houses were found with a higher proportion of TB. 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