Incidence of tuberculosis in people living with the human immunodeficiency virus in Saudi Arabia.
OBJECTIVE
To identify the incidence of tuberculosis (TB) in people living with the human immunodeficiency virus (HIV) (PLWH) followed at an HIV referral and care facility.


METHODS
Observational longitudinal cohort.


METHODS
Data were collected longitudinally as patients were admitted to the HIV programme and included demographics, TB diagnosis and treatment, CD4+ T lymphocyte count and TB treatment outcomes. The TB-free follow-up period of all patients was used to calculate TB incidence rates.


RESULTS
Between 1997 and 2007, 217 new adult patients joined the HIV programme. TB was diagnosed in 16 patients (7.4%), all of whom had acquired immune-deficiency syndrome at the time of TB diagnosis. Seven developed extra-pulmonary disease (44%), six had pulmonary TB (37%), while three had both (19%). The TB incidence rate was 1354 per 100,000 person-years (py) among the HIV-infected cohort. The incidence rate of pulmonary TB was 762/100,000 py and for extra-pulmonary TB it was 592/100,000 py. Seven patients (44%) died despite early diagnosis and treatment for TB.


CONCLUSIONS
Among PLWH in Saudi Arabia, TB incidence is 30 times higher than in the general population, with significant mortality despite early diagnosis, treatment and tertiary care support.
Omair
M A
MA
Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Al-Ghamdi
A A
AA
Alrajhi
A A
AA
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012529:Saudi Arabia / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult