DOES HIV COINFECTION AFFECT THE OUTCOME OF ANTITUBERCULOSIS TREATMENT?

Background: Tuberculosis (TB) is a major problem in developing countries, including Indonesia. One of the most important risk factors for developing active TB is HIV coinfection. Thus, HIV increases global burden of TB and TB is one of the leading causes of death among people with HIV. HIV patients have up to 20 times higher risk of developing active TB compared to those without HIV infection. Treatment and management of tuberculosis in HIV patients are challenging, mostly due to inadequate diagnostics and treatment. Method: The study was conducted in 2014 using a retrospective case-control method (unsuccess TB treatment patients as case group; successful TB as control group) with purposive sampling technique. Demographic data, TB treatment, and outcome therapy were documented and analyzed to determine factors affecting successful TB treatment in HIV/TB coinfection patients. Statistical analysis was performed using univariate and multivariate logistic regression model. Objectives: This study was aimed to analyze the outcomes of the TB treatment in HIV/TB coinfection in Bandung and the affecting factors. Result: 531 patients (85 cases; 446 controls) were involved in this study. Demographic data showed that 7,7% of patients were HIV/TB coinfection patients and most patients (78,05%) received category 1 of antituberculosis drugs. HIV coinfection independently affected the success of TB treatment. The successful rate of TB treatment in Bandung was 83,9%. TB patients with HIV positive tended to be 2,740 times less likely to succeed in TB treatment compared to TB patients with HIV negative [OR=2,740; 95% CI (1.051-7.140), p=0.039*]. Factors affecting the successful outcome of TB treatment is gender (woman>man, p<0,05), location/access to medication (p<0,05), and the AFB-negative conversion during intensive phase of treatment (p<0,01). Conclusion: HIV coinfection lower the successful rate of TB treatment with odds ratio 2,740. Factors affecting the successful rate of TB treatment are gender, access to medication, and AFB conversion during intensive phase of treatment. Keywords: HIV/TB coinfection; treatment outcomes, factors.