The survival rate of tuberculosis patients in HIV-treated cohort of 2008-2018 in Almaty, Kazakhstan

  • Ainur Zhandybayeva Almaty City Center of Prevention and Control of AIDS, Almaty, Kazakhstan
  • Nune Truzyan FMD KL Europe, Yerevan, Armenia
  • Elina Shahumyan FMD KL Europe, Yerevan, Armenia
  • Aizat Kulzhabaeva USAID Defeat TB Project in Kyrgyz Republic, Bishkek, Kyrgyzstan
  • Zhamilya Nugmanova Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
  • Alfiya Denebayeva Almaty City Center of Prevention and Control of AIDS, Almaty, Kazakhstan
  • Marat Tukeyev Almaty City Center of Prevention and Control of AIDS, Almaty, Kazakhstan
Keywords: tuberculosis, HIV, survival, SORT IT

Abstract

Introduction: HIV/TB comorbidity is responsible for 1.6 million deaths worldwide. HIV/TB control and patients’ survival are still among priorities of the national HIV and TB programs. We aimed to evaluate the HIV/TB survival in connection with TB treatment outcomes and factors influencing life duration of the cohort 2008-2018 in Almaty, Kazakhstan.

Methodology: This retrospective cohort study extracted data for all HIV and pulmonary TB adults coinfected during 2008-2018 in Almaty from national registries to apply descriptive, Kaplan-Meier estimation, and Cox proportional hazards regression model. Survival function for the TB treatment outcomes and factors predicting the probability of survival were tested and described.

Results: The cohort population (n = 521) mean age was 37.4 years with 405 (77.7%) males and 210 (40.3%) marrieds. More than one TB treatment had 181 (34.7%) patients, 291 (55.9%) were smear-positive (SS+), and 423 (81.2%) were on antiretroviral therapy with mean CD4 count 254.22cells/µL. Probability to live longer was higher (128 versus 37 months, p = 0.003; 95% confidence interval (CI) 71.65, 184.35) for those who succeeded in TB treatment compared to “lost to follow-up” and “failed” treatment outcomes. Adjusted Cox regression model death hazard showed association with missing ART treatment (HR: 1.699, 95%CI 1.164, 2.481, p = 0.006) and having CD4 count < 499 (HR 2.398, 95%CI 1.191, 4.830, p < 0.014).

Conclusion: TB treatment outcomes, ART treatment, and the CD4 count of HIV/TB coinfected population substantially influence their life duration. The medical decision- and policy-makers should take this into consideration when implementing targeted improvements in the national HIV and TB programs.

Published
2020-11-16
How to Cite
1.
Zhandybayeva A, Truzyan N, Shahumyan E, Kulzhabaeva A, Nugmanova Z, Denebayeva A, Tukeyev M (2020) The survival rate of tuberculosis patients in HIV-treated cohort of 2008-2018 in Almaty, Kazakhstan. J Infect Dev Ctries 14:116S-121S. doi: 10.3855/jidc.11955
Section
SORT IT TB Key Population