Particularities of people who inject drugs in a HIV-TB cohort

<b>Introduction:</b> Human immunodeficiency virus (HIV) - tuberculosis (TB) coinfection represents a severe pathology, with high mortality and poorer treatment outcome. Among these patients, people who inject drugs (PWID) represent a special category, with low adherence and high failure rates. <b>Aims:</b> To describe peculiarities of PWID with HIV-TB coinfection, regarding demographics, diseases, treatment outcome. <b>Method:</b> We evaluated all HIV-TB patients treated in our TB unit in Bucharest, Romania,&nbsp;during 2009-2018. We compared PWID with those not injecting drugs. <b>Results:</b> We identified 122 patients with coinfection (5.47% of all TB patients treated in our unit), 60 of them PWID, 58 non-drug users, and 4 former users (the last were excluded from the analysis). Mean age of PWID was 33.05 years; most of them (54) were male. A number of 51 patients had pulmonary TB. Mean CD4 value was 157.18/mm3 and 39 patients were treated with antiretroviral (ARV) drugs. Viral hepatitis was present in 58 cases. TB treatment success was noted in 32 patients, 18 patients died, 6 abandoned and 4 were lost in follow up. Comparing PWID with those not injecting drugs, we obtained the next differences: younger age for PWID (p&lt;0.0001), more male predominance (p=0.0034), fewer patients on ARV treatment (p=0.0075) and poorer TB treatment outcome (p=0.0373). <b>Conclusion:</b> The results confirm a poorer TB treatment outcome for PWID, and also a lower proportion of patients using ARV treatment. Together, these two factors put the patient with HIV-TB who uses injectable drugs at high mortality and morbidity risks. All efforts should be made to maintain treatment adherence&nbsp;of PWID&nbsp;with HIV-TB coinfection.