PREDICTORS OF PULMONARY TUBERCULOSIS CO-INFECTION AMONG HIV PATIENTS IN KHZ MUSTHAFA HOSPITAL: A CROS-SECTIONAL STUDY

Siti Novianti(1*), Dania Puji Lestari(2), Nur Lina(3), Diah Wijayanti Sutha(4)
(1) Program Studi Kesehatan Masyarakat, Fakultas Ilmu Kesehatan, Universitas Siliwangi
(2) Universitas Siliwangi
(3) Universitas Siliwangi
(4) Stikes Yayasan Dr. Soetomo
(*) Corresponding Author
DOI : 10.30604/jika.v10i2.3278

Abstract

HIV infection increases the burden of pulmonary TB, especially in populations with a high prevalence of pulmonary TB, including in Indonesia. People with HIV infection become susceptible to other infections, including pulmonary TB. This study aims to analyze the determinants associated with the occurrence of pulmonary TB co-infection among HIV-positive patients. The study design used a crossectional study based on patient medical records, conducted on all HIV-positive patients at KHZ Mushtafa Regional Hospital, Tasikmalaya Regency, from 2022-2023 and obtained 140 respondents. Research subjects with incomplete medical records were excluded from the study. Demographic and clinical data were analyzed using SPSS to process univariate, bivariate data, and multiple logistic regression at a 95% confidence interval. A total of 59.2% of HIV patients suffered from pulmonary TB co-infection. The average age of patients was 30.7 years; 77.8% were male; 75.9% were married; and 69.3% were employed. Multivariate analysis results showed that clinical stage (p=0.009; OR 2.9 (1,319-6,734), duration of ARV therapy (p<0.001, OR=5.3 (2,246-12,474), and the presence of other opportunistic infections (p<0.001, OR=4.6 (1,963-11,005)) were the significant predictors  of TB/HIV co-infection at KHZ Musthafa Regional Hospital, Tasikmalaya Regency. The high prevalence of pulmonary TB indicates low screening in at-risk population groups. Integrated and comprehensive services for pulmonary TB and HIV diagnosis and treatment are needed for better management of TB/HIV co-infection.

Keywords


risk factors, co-infection pulmonary TB, HIV patients

References


Anindita, F. S., Indriani, F., Murti, B., & Veibiani, N. A. (2024). Factors Affecting Mortality in People Living with HIV with Antiretroviral Therapy: A Meta-Analysis. Journal of Epidemiology and Public Health, 9(4), 480–494. https://doi.org/10.26911/jepublichealth.2024.09.04.08

Asmarawati, T. P., Putranti, A., Rachman, B. E., Hadi, U., & Nasronudin. (2018). Opportunistic infection manifestation of HIV-AIDS patients in Airlangga university hospital Surabaya. IOP Conference Series: Earth and Environmental Science, 125(1). https://doi.org/10.1088/1755-1315/125/1/012061

Badje, A., Moh, R., Gabillard, D., Guéhi, C., Kabran, M., Ntakpé, J. B., Carrou, J. Le, Kouame, G. M., Ouattara, E., Messou, E., Anzian, A., Minga, A., Gnokoro, J., Gouesse, P., Emieme, A., Toni, T. d. A., Rabe, C., Sidibé, B., Nzunetu, G., … Anglaret, X. (2017). Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial. The Lancet Global Health, 5(11), e1080–e1089. https://doi.org/10.1016/S2214-109X(17)30372-8

Eze, T. O., Nwadinigwe, F. C., & Ameh, G. M. (2023). Treatment Outcome of Tuberculosis Cases and HIV Co-infected Patients. A Retrospective Study at a Federal Medical Centre of North Central Nigeria. Jurnal Epidemiologi Kesehatan Komunitas, 8(1), 6–13. https://doi.org/10.14710/jekk.v8i1.17221

Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdollahi, A., Abdullahi, A., Abegaz, K. H., Zuñiga, R. A. A., Aboagye, R. G., Abolhassani, H., Abreu, L. G., Abualruz, H., Abu-Gharbieh, E., Abu-Rmeileh, N. M. E., … Murray, C. J. L. (2024). Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systema. The Lancet, 403(10440), 2133–2161. https://doi.org/10.1016/S0140-6736(24)00757-8

Fuseini, H., Gyan, B. A., Kyei, G. B., Heimburger, D. C., & Koethe, J. R. (2021). Undernutrition and HIV Infection in Sub-Saharan Africa: Health Outcomes and Therapeutic Interventions. Current HIV/AIDS Reports, 18(2), 87–97. https://doi.org/10.1007/s11904-021-00541-6

Ghosh, S., Mandal, S., Chakrabarti, M., & Dey, A. (2024). Factors associated with tuberculosis among PLHIV: An observational study in a Government Medical College in West Bengal, India. Clinical Epidemiology and Global Health, 29(July), 101729. https://doi.org/10.1016/j.cegh.2024.101729

Gumilang, R. R., Indriati, D. W., Diyantoro, D., & Sundari, A. S. (2022). The Occurrence of Tuberculosis Infection among Newly HIV Diagnosed Patient in Indonesia. Open Access Macedonian Journal of Medical Sciences, 10(A), 893–896. https://doi.org/10.3889/oamjms.2022.9529

Hoffmann, C., Maglakelidze, M., von Schneidemesser, E., Witt, C., Hoffmann, P., & Butler, T. (2022). Asthma and COPD exacerbation in relation to outdoor air pollution in the metropolitan area of Berlin, Germany. Respiratory Research, 23(1), 1–9. https://doi.org/10.1186/s12931-022-01983-1

Hulu, V. T., Ginting, R., Manalu, P., Samosir, F. J., Hartono, H., Siregar, S. D., Siagian, M., Zendrato, V. N., & Sihotang, W. Y. (2024). The Impact of Tuberculosis on People Living With HIV: Scoping Review. Public Health of Indonesia, 10(3), 262–273. https://doi.org/10.36685/phi.v10i3.804

Jayani, I., Susmiati, Winarti, E., & Sulistyawati, W. (2020). The Correlation between CD4 Count Cell and Opportunistic Infection among HIV/AIDS Patients. Journal of Physics: Conference Series, 1569(3). https://doi.org/10.1088/1742-6596/1569/3/032066

Karyadi, T. H. (2017). Keberhasilan Pengobatan Terapi Antiretroviral. Jurnal Penyakit Dalam Indonesia, 4(1), 1. https://doi.org/10.7454/jpdi.v4i1.105

Kementerian Kesehatan Indonesia, D. J. P. dan P. (2023). Laporan Program Penanggulangan Tuberkulosis Tahun 2022. Kemenkes RI, 1–147. https://tbindonesia.or.id/pustaka_tbc/laporan-tahunan-program-tbc-2021/

Kementerian Kesehatan RI. (2023). Petunjuk Teknis Kolaborasi TBC HIV.

Kurniawati, V. V., Harioputro, D. R., & Susanto, A. J. (2022). Evaluasi Kadar Sel Cd4, Viral Load, Dan Neutrophil Lymphocyte Ratio (Nlr) Terhadap Infeksi Oportunistik Pada Pasien Hiv/Aids. Biomedika, 14(2), 99–107. https://doi.org/10.23917/biomedika.v14i2.17299

Kusumawati, P. K., Saraswati, L. D., Martini, M., & Hestiningsih, R. (2021). GAMBARAN PENGETAHUAN PETUGAS TB-HIV DALAM PENEMUAN DAN AKSES PENGOBATAN (Studi di Layanan Komprehensif Berkesinambungan di Puskesmas Kota Semarang). Jurnal Kesehatan Masyarakat (Undip), 9(4), 497–503. https://doi.org/10.14710/jkm.v9i4.29764

Lawn, S. D., Wood, R., & Wilkinson, R. J. (2011). Changing concepts of “latent tuberculosis infection” in patients living with HIV infection. Clinical and Developmental Immunology, 2011. https://doi.org/10.1155/2011/980594

Lestari, N., & Yaasiin, P. I. M. (2024). Hubungan indeks massa tubuh dan Diabetes Melitus terhadap kesembuhan pasien Tuberkulosis Paru. CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal, 5(2), 181–187.

Mirahmadizadeh, A., Sharafi, M., Hassanzadeh, J., & Seif, M. (2023). Prevalence and risk factors associated with tuberculosis and HIV coinfection in Iran: A multivariate firth logistic regression for rare events. Journal of Infection in Developing Countries, 17(12), 1775–1781. https://doi.org/10.3855/jidc.17439

Mulyadi. (2011). STUDI KASUS : PENDERITA HIV / AIDS YANG DIRAWAT DENGAN PENYULIT TUBERKULOSIS PARU Case Study : People with HIV / AIDS Disease are treated with Pulmonary Tuberculosis. Idea Nursing Journal, 2(2087–2879), 125–131.

Nainggolan, O., Sasmithae, L., & Widayati, R. (2023). The Effect of Antiretroviral Therapy (ART) Duration on CD4 Counts in Human Immunodeficiency Virus (HIV) Patients in dr. Doris Sylvanus Regional Hospital. Jurnal Kedokteran Brawijaya, 32(4), 228–232. https://doi.org/10.21776/ub.jkb.2023.032.04.5

Noursadeghi, M., & CK Bell, L. (2018). Pathogenesis of HIV-1 and Mycobacterium tuberculosis co-infection. Nat Rev Microbiol, 16(2), 80–90. https://pubmed.ncbi.nlm.nih.gov/29109555/

Pertiwi, I., Windiyaningsih, C., Rusli, A., & Murtiani, F. (2023). Ko-Infeksi HIV-TB: Studi Cross Sectional. Jurnal Kesehatan Komunitas, 9(1), 173–181. https://doi.org/10.25311/keskom.vol9.iss1.1303

Puspitasari, E., Yunihastuti, E., Rengganis, I., & Rumende, C. M. (2016). Predictors of Mortality in Hospitalized HIV / AIDS Patients Prediktor Mortalitas Pasien HIV / AIDS Rawat Inap. Jurnal Penyakit Dalam Indonesia, 3(1), 22–28.

Putri, V., Botutihe, A., Jusuf, H., Arsad, N., & Penelitian, A. (2023). Analisis Faktor yang Berhubungan dengan Tingkat Kepatuhan Minum Obat Pasien Ko-Infeksi TB-HIV di Kota Gorontalo. J J Jurnal Kolaboratif Sains, 7(8), 3006–3016. https://doi.org/10.56338/jks.v7i8.5621

Rego de Figueiredo, I., Branco Ferrão, J., Dias, S., Vieira Alves, R., Drummond Borges, D., Torres, M., Guerreiro Castro, S., Lourenço, F., Antunes, A. M., Gruner, H., & Panarra, A. (2021). Tuberculosis infection in HIV vs. non-HIV patients. HIV Medicine, 22(8), 775–779. https://doi.org/10.1111/hiv.13119

Selimin, D. S., Ismail, A., Ahmad, N., Ismail, R., Mohd Azman, N. F., & Azman, A. (2021). Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia. Journal of Tropical Medicine, 2021. https://doi.org/10.1155/2021/9923378

Sitorus, R. J., Murinata, J., Antara, N. Y., Sangalang, R. V., & Panjaitan, M. N. (2024). Epidemiological Aspects of Hiv-Tb Co-Infection in People With Hiv/Aids (Plwha): a Hospital-Based Study. Indonesian Journal of Public Health, 19(3), 419–429. https://doi.org/10.20473/ijph.v19i3.2024.419-429

Suthar, A. B., Ford, N., Bachanas, P. J., Wong, V. J., Rajan, J. S., Saltzman, A. K., Ajose, O., Fakoya, A. O., Granich, R. M., Negussie, E. K., & Baggaley, R. C. (2013). Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches. PLoS Medicine, 10(8). https://doi.org/10.1371/journal.pmed.1001496

Sutini, Rahayu, S. R., Saefurrohim, M. Z., Al Ayubi, M. T. A., Wijayanti, H., Wandastuti, A. D., Miarso, D., & Susilastuti, M. S. (2022). Prevalence and Determinants of Opportunistic Infections in HIV Patients: A Cross-Sectional Study in the City of Semarang. Ethiopian Journal of Health Sciences, 32(4), 809–816. https://doi.org/10.4314/ejhs.v32i4.18

Swinkels, M. H., Nguyen, A. D., & Gulick, P. G. (2025). HIV and Aids. In HIV and AIDS. StatPearls Publishing.

Teshome, B., Kogi-Makau, W., Getahun, Z., & Taye, G. (2010). Magnitude and determinants of stunting in children underfive years of age in food surplus region of Ethiopia: The case of West Gojam Zone. Ethiopian Journal of Health Development, 23(2). https://doi.org/10.4314/ejhd.v23i2.53223

Trisnashanti, D. P., & Romdhoni, A. C. (2025). ANALYSIS FACTORS AFFECTING OPPORTUNISTIC. 9(1), 88–97. https://doi.org/10.20473/imhsj.v9i1.2025.88-97

Triwicaksana, A. A. F., Rusli, M., Vitanata Arfijanto, M., Bramantono, Nasronudin, & Hadi, U. (2022). A patient with CD4+ T cells deficiency and HIV negative with pulmonary tuberculosis, tuberculous pleuritis and meningitis tuberculosis. Bali Medical Journal, 11(2), 597–601. https://doi.org/10.15562/bmj.v11i2.3458

UNAIDS. (2024). the Urgency of Now: AIDS at a crossroads.

Wardah, W., & Melinda, R. (2019). Tuberculosis Coinfection Risk Towards People with HIV/AIDS in Care, Support, and Treatment Polyclinic Santa Maria Hospital Pekanbaru. KnE Life Sciences, 4(10), 1. https://doi.org/10.18502/kls.v4i10.3823

WHO. (2023). Epidemiological Fact Sheet: HIV statistics, globally and by WHO region, 2023. HIV Data and Statistics, Last accessed 14/04/2024. https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/j0294-who-hiv-epi-factsheet-v7.pdf?sfvrsn=5cbb3393_7

Windels, E. M., Wampande, E. M., Joloba, M. L., Boom, W. H., Goig, G. A., Cox, H., Hella, J., Borrell, S., Gagneux, S., Brites, D., & Stadler, T. (2024). HIV co-infection is associated with reduced Mycobacterium tuberculosis transmissibility in sub-Saharan Africa. PLoS Pathogens, 20(5 May), 1–21. https://doi.org/10.1371/journal.ppat.1011675

Wong, K., Nguyen, J., Blair, L., Banjanin, M., Grewal, B., Bowman, S., Boyd, H., Gerstner, G., Cho, H. J., Panfilov, D., Tam, C. K., Aguilar, D., & Venketaraman, V. (2020). Pathogenesis of human immunodeficiency virus-mycobacterium tuberculosis co-infection. Journal of Clinical Medicine, 9(11). https://doi.org/10.3390/jcm9113575

World Health Organization. (2023). Global Tuberculosis Report. In January (Issue March).

Xiao, P., Chen, X., Chen, Y., Fan, W., Dong, Z., Huang, J., & Zhang, Y. (2023). CD4+T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review. Open Life Sciences, 18(1). https://doi.org/10.1515/biol-2022-0744


Article Statistic

Abstract view : 371 times
PDF (Bahasa Indonesia) views : 266 times

Dimensions Metrics

How To Cite This :

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.