Jul 2026· The International Journal of Tuberculosis and Lung Disease· Vol 30 8, pp.
358-364
· 0 citations
Medicine
TL;DR
TB incidence among PLHIV in South Korea has declined over the past decade, but mortality during TB treatment remains high, driven largely by host-related factors including age and comorbidities.
Abstract
BACKGROUNDRecent trends and treatment outcomes of TB among people living with HIV (PLHIV) have been understudied in Korea.METHODSUsing the nationwide K-TB-N cohort, we identified individuals with TB registered between 2011 and 2022. Among 373,812 TB cases, 931 had TB-HIV co-infection. TB treatment outcomes were compared between PLHIV and the general population using propensity score matching. Multivariable Cox proportional hazards models, including stratified and sensitivity analyses, were used to identify factors associated with death during TB treatment among PLHIV.RESULTSMost of TB-HIV patients were males (91.9%), under 60 years old (82.1%), and approximately 90% received antiretroviral therapy (ART). The number of TB-HIV cases declined from 120 in 2011 to 35 in 2022. Lost to follow-up and not evaluated outcomes decreased over time, whereas mortality remained stable at 10%-20%. The overall TB treatment success rate was 76.9% and mortality was higher than general population. Mortality was associated with older age and comorbidity burden, whereas ART showed a protective association only when initiated before TB diagnosis.CONCLUSIONTB incidence among PLHIV in South Korea has declined over the past decade, but mortality during TB treatment remains high, driven largely by host-related factors including age and comorbidities..
The incidence of LTFU among adults on ART in Guji zone was high, particularly during the first year of treatment, and targeted interventions including enhanced counseling for high-risk groups, community-based ART refill models, and active phone-based tracking systems should be implemented to improve retention.
Tuberculosis (TB) is the leading cause of death among people living with HIV (PLHIV). Kazakhstan faces a growing number of new HIV diagnoses alongside a high incidence of multidrug-resistant TB. This study aimed to determine the prevalence and risk factors for TB among PLHIV in Almaty, Kazakhstan.
We conducted a cross-sectional study of adult PLHIV receiving care at the Almaty AIDS City Center by 2022. Participants were randomly selected from the HIV registry. TB/HIV coinfection was defined as a documented TB diagnosis following HIV diagnosis in the registry. Bivariable and multivariable Poisson regression with robust standard errors was used to estimate unadjusted and adjusted prevalence ratios (PR and aPR) and 95% confidence intervals (CI) for factors associated with TB/HIV coinfection.
Of 194 PLHIV randomly selected, 188 participated, of whom 32 (17%) had TB/HIV coinfection. In bivariable analysis, coinfection was more common among those with lower educational attainment (24% vs. 6%), a history of incarceration (43% vs. 11%), ever smoking (32% vs. 4%), known TB contact (28% vs. 5%), detectable viral load (>50 copies/mL; 42% vs. 3% among those with undetectable viral load ≤50 copies/mL), ART duration less than three years (13% vs. 1%), and ART interruptions (16% vs. 3%). Coinfection prevalence was also higher among those with a CD4 cell count <200 cells/mm
3
(44% vs. 12%), and those with no or unknown TPT receipt had a higher prevalence of coinfection compared to those who had received TPT (25% vs. 10%; PR = 2.5; 95% CI: 1.2–5.5). In multivariable analysis, coinfection was independently associated with younger age (18–39 vs. ≥40 years; aPR = 2.0; 95% CI: 1.2–3.4), ever smoking (aPR = 3.6; 95% CI: 1.3–10.0), known TB contact (aPR = 2.4; 95% CI: 1.0–5.7), incarceration history (aPR = 1.8; 95% CI: 1.1–3.2), and detectable viral load (aPR = 6.9; 95% CI: 2.5–19.5).
We found a high prevalence of TB/HIV coinfection and suboptimal TPT coverage among PLHIV in Almaty. Expanding TPT access, ensuring routine TB screening, and prioritizing early and sustained ART, particularly among individuals with detectable viral loads or low CD4 counts, may help reduce TB among PLHIV in similar settings.
Alfiya Y. Denebayeva, Elizabeth J. King, Zhamilya Nugmanova et al.· Frontiers in Public Health· 0 citations
Mortality among PLHIV in this study was associated with advanced disease, opportunistic diseases, commorbidities and abnormal laboratory findings, and Strengthening early diagnosis, management of opportunistic infections, and monitoring of clinical and laboratory indicators may help reduce mortality in this population.
Faustus Ajamah, Jude Tsafack Zefack, Lucas Tanlaka Mengnjo et al.· World Journal of Advanced Re...· 0 citations
Background Globally, one-in-two childhood tuberculosis (TB) case remains undiagnosed, and TB remains a leading cause of death among children under 15 years despite favorable treatment outcomes. This study assessed trends in case notification and outcomes among children with TB across ten regions of Tanzania. Methods We conducted a retrospective cross-sectional study using data from Tanzania's national electronic TB and Leprosy System for children diagnosed between 2018 and 2023. Mann-Kendall Tests were used to assess the existence of monotonic trends in TB notifications, and distribution of outcomes was analyzed using Wilcoxon rank-sum test or Pearson's Chi-squared test, and binary logistic regression at a 5% significance level. Results 25,449 childhood TB cases were notified over six-year period, with 14.4% (n = 3667) HIV/TB co-infected. Case notifications increased from 2688 in 2018 to a peak of 5421 in 2022 then declined to 4493 in 2023 (p = 0.047). Significant differences in unfavorable treatment outcomes were observed between pre- and post-COVID-19 periods (OR 0.52, 95% CI 0.44–0.60). TB/HIV co-infection cases declined from 28.5% (n = 766) in 2018 to 8.9% (n = 400) in 2023 (p = 0.002), while HIV-negative cases rose markedly (p = 0.027). Overall, 97.2% of children achieved favorable outcomes. Unfavorable outcomes were common among children who were HIV/TB co-infected, under five years, and 10–15 years. Conclusion Childhood TB case notifications increased significantly from 2018 to 2023, indicating improved detection, though with notable regional and HIV-related disparities. Treatment outcomes were generally favorable. HIV-positive children and older age groups faced higher risks of unfavorable outcomes. Targeted interventions are needed to address disparities in case detection and treatment success.
Evance N.Mgeyi, Florence S.Kalabamu, Onduru G.Onduru et al.· Journal of Clinical Tubercul...· 0 citations
Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV (PLHIV) despite the availability of effective preventive interventions. Tuberculosis Preventive Therapy (TPT), strongly recommended by the World Health Organization, substantially reduces the risk of active TB among PLHIV, however, uptake of TPT remains suboptimal in many settings. This study, therefore, assessed the predictors of TPT initiation, beginning the course of anti-TB medications among PLHIV.
This was a health facility-based analytical cross-sectional study among 806 PLHIV aged
≥
18 years attending antiretroviral therapy (ART) clinics in the Volta Region of Ghana. A systematic sampling technique was employed to recruit respondents, and data were collected using structured questionnaires mounted in the Kobo Toolbox. Data was exported to Stata version 17.0 for analysis. Descriptive and logistic regression analyses were performed, with statistical significance set at a
p
< 0.05 at 95% confidence interval.
Our study found that out of the 806 PLHIV recruited, with a mean age of 44.7 years (SD ± 13), the majority, 481 (59.70%), were found to have poor knowledge of TPT. We found that 620/806 (88.6%) PLHIV were eligible for TPT, and among those eligible, only 236 (38.1%) were initiated on TPT. Respondents who had good knowledge of TPT were about 7 times more likely to be initiated compared with those who had poor knowledge (aOR = 6.79, 95% CI 4.69–9.83,
p
< 0.001). Those who had been diagnosed with HIV for one year or more were 4 times as likely to be initiated as those diagnosed for less than a year (aOR = 4.18, 95% CI 1.74–10.04,
p
= 0.001). Respondents in HIV clinical stage 2 were 66% less likely to be initiated than those in stage 1 (aOR = 0.34, 95% CI 0.20–0.58,
p
< 0.001). With respect to marital status, married respondents were 40% less likely to be initiated on TPT compared with single respondents (aOR = 0.60, 95% CI 0.37–0.97,
p
= 0.038). Barriers perceived by PLHIV to TPT initiation were distance to facility, poor health education, and limited drug availability.
TPT initiation among PLHIV in the Volta Region was suboptimal, and key predictors of initiation were TPT knowledge, duration since HIV diagnosis, HIV clinical stage, and marital status. Strengthening patient education, ensuring consistent drug and logistics availability, and addressing implementation barriers are critical to improving uptake and advancing progress toward Sustainable Development Goal 3.3 targets.
Felix Mbiba, Raham Agbenorku Yaw Tawiah, Joyce B Der· BMC Public Health· 0 citations
BACKGROUND
Tuberculosis (TB) is a significant cause of mortality among people living with HIV (PLWH), in Nepal. HIV increases the risk of progression from latent to active TB, increasing mortality. Despite established TB control programs, there is a significant lack of recent data measuring the tuberculosis burden among PLWH specially within the Western region of Nepal. This study was conducted to assess the prevalence of pulmonary tuberculosis among HIV-positive patients attending a tertiary care centre in Gandaki Province, Nepal.
METHODS
A hospital-based cross-sectional study was conducted at Western Regional Hospital, Pokhara Academy of Health Sciences, from August 2025 to January 2026. First, HIV-positive patients attending the ART clinic were screened, and those aged ?18 years without prior tuberculosis were included. Next, participants were recruited using convenience sampling. After obtaining informed consent, sociodemographic and clinical data were collected through a structured questionnaire and medical record review. Subsequently, CD4 counts were measured using the PIMA CD4 analyser, and sputum samples were examined using Ziehl-Neelsen staining for acid-fast bacilli. Finally, data were analysed using SPSS version 22, with p < 0.05 considered statistically significant.
RESULTS
Prevalence of pulmonary TB was found to be 5.1% among 137 participants. TB co-infection was found to be higher among males and in the 20-29 years and >70 years age groups. TB was more common among those with CD4 counts <200 cells/µL, but was not statistically significant.
CONCLUSIONS
The study found a 5.1% prevalence of pulmonary TB among PLWH in western Nepal and highlights the need for regular TB screening.
Shisir Pokhrel, S. Regmi, Kripa Ghimire et al.· Journal of Nepal Health Rese...· 0 citations