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Incidence Rate and Risk Factors for Tuberculosis among People Living with HIV: A 2015–2017 Cohort from Tashkent, Uzbekistan

Dilbar SadirovaCenter of Phthisiology and Pulmonology of Tashkent City, Tashkent 100043, UzbekistanRuzanna GrigoryanNargiza ParpievaRepublican Specialized Scientific Practical Medical Center of Phthisiology and Pulmonology, Tashkent 100043, UzbekistanVenera BarotovaTashkent City AIDS Center, Tashkent 100043, UzbekistanAleksandr TrubnikovCenter of Phthisiology and Pulmonology of Tashkent City, Tashkent 100043, UzbekistanLola KalandarovaCenter of Phthisiology and Pulmonology of Tashkent City, Tashkent 100043, UzbekistanJamshid GadoevDavron MukhtarovTashkent Institute of Postgraduate Medical Education, Tashkent 100043, UzbekistanMariana BuziashviliNational Center for Tuberculosis and Lung Diseases, Tbilisi 01790101, GeorgiaNestani TukvadzeNational Center for Tuberculosis and Lung Diseases, Tbilisi 01790101, GeorgiaArax HovhannesyanWorld Health Organization, Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, DenmarkAndrei DaduWorld Health Organization, Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
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People living with the human immunodeficiency virus (PLHIV) have a higher risk of developing active tuberculosis (TB) disease, and TB remains a major cause of death in PLHIV. Uzbekistan is facing a substantial TB epidemic, which increases the risk of PLHIV developing active TB. Our retrospective cohort study aimed to evaluate the incidence rate and assess the risk factors for developing active TB among PLHIV. We collected secondary data extracted from medical charts of all patients, newly diagnosed at the AIDS Center in Tashkent, during the period of 2015–2017. The incidence rate of TB among PLHIV was 5.1 (95% CI: 4.5–6.0) per 1000 person/month. Adjusted regression analysis showed three major risk factors for TB, namely, being less than 15 years old (hazard ratio (HR) 5.83; 95% CI: 3.24–10.50, p value = 0.001),low CD4 count (adjusted hazard ratio(aHR) 21.0; 95% CI: 9.25–47.7, p value < 0.001), and antiretroviral therapy (ART) interruption/not receiving ART (aHR 5.57; 95% CI: 3.46–8.97 and aHR 6.2; 95% CI: 3.75–10.24, p value < 0.001, respectively) were significantly associated with developing active TB among PLHIV. Our findings indicate that taking prescribed ART without interruptions and maintaining CD4cell counts higher than 320 cells/μL are essential to prevent the development of active TB among PLHIV.

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