title: Tuberculosis and human immunodeficiency virus co-infections and their predictors at a hospital-based HIV/AIDS clinic in Uganda.
abstract: METHODS
  Mulago Hospital, Uganda.
  
  
  OBJECTIVE
  To evaluate the burden of TB-HIV (tuberculosis-human immunodeficiency virus) co-infections and their predictors in an urban hospital-based HIV programme.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Clinicians screened all patients with HIV/AIDS (acquired immune-deficiency syndrome) for previous and current TB treatment at enrolment and throughout follow-up.
  
  
  RESULTS
  Of 10,924 patients enrolled between August 2005 and February 2009, co-prevalent TB was 157/10,924 (1.4%), which included 88/157 (56%) with TB confirmed at enrolment and 65/157 (41%) with TB diagnoses established during follow-up in whom symptoms were present at enrolment. Male sex (adjusted odds ratio [aOR] 2.3, 95%CI 1.6-3.2) and body mass index (BMI) ≤ 20 kg/m(2) (aOR 3.8, 95%CI 2.5-5.4) were associated with co-prevalent TB. Overall, 749/10,767 (7%) were diagnosed with incident TB at a higher rate among antiretroviral treatment (ART) patients (8/100 patient years of observation [PYO]) than non-ART patients (5/100 PYO, log rank P < 0.001). Female sex (adjusted hazard ratio [aHR] 1.4, 95%CI 1.2-1.7) and baseline BMI ≤ 20 (aHR 1.9, 95%CI 1.6-2.2) predicted incident TB.
  
  
  CONCLUSIONS
  Routine TB screening in the HIV/AIDS care programme identified a significant number of TB-HIV co-infections among patients with and without ART, and is therefore a potential strategy to improve HIV treatment outcomes in resource-limited settings.
authors.affiliation: Department of Medicine, Makerere University School of Medicine, Kampala, Uganda. drdamalie@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Nakanjako
authors.forename: H
authors.initials: H
authors.lastname: Mayanja-Kizza
authors.forename: J
authors.initials: J
authors.lastname: Ouma
authors.forename: R
authors.initials: R
authors.lastname: Wanyenze
authors.forename: D
authors.initials: D
authors.lastname: Mwesigire
authors.forename: A
authors.initials: A
authors.lastname: Namale
authors.forename: J
authors.initials: J
authors.lastname: Ssempiira
authors.forename: J
authors.initials: J
authors.lastname: Senkusu
authors.forename: R
authors.initials: R
authors.lastname: Colebunders
authors.forename: M R
authors.initials: MR
authors.lastname: Kamya
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology*; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D014454:Uganda / Q000453:epidemiology