Factors Associated with Prevalent Tuberculosis Among Patients Receiving Highly Active Antiretroviral Therapy in a Nigerian Tertiary Hospital

Background: Tuberculosis (TB) causes significant morbidity/mortality among humanimmunodeficiency virus‑infected individuals in Africa. Reducing TB burden in the eraof highly active antiretroviral therapy (HAART) is a public health priority. Aim: Wedetermined the factors associated with prevalent TB among patients receiving HAART.Subjects and Methods: We conducted a cross‑sectional study of adult patients who hadreceived HAART for ≥12 weeks in a Nigerian tertiary hospital. Patients whose TB diagnosispredated HAART were excluded from the study. Pre‑HAART data were collected from theclinic records, whereas post‑HAART data were obtained through medical history, physicalexamination, and laboratory investigations. Standard TB screening/diagnostic algorithmsas applicable in Nigeria were used. Logistic regression analysis was used to determinefactors independently associated with prevalent TB. Results: about 65.8% (222/339) were women. The mean age was 41.1 (10.0) years and 23.6% (73/339) had past history of TB. The prevalence of active TB was 7.7% (26/339). Among these patients, 42.3% (11/26) had pulmonary TB, 34.6% (9/26) had disseminated TB, whereas 23.1% (6/26) had only extra‑pulmonary disease. Only 45% (9/20) of patients with pulmonary involvement had positive sputum smear. Factors independently associated with prevalent TB were lower social class (adjusted odds ratio [aOR]: 31.7; 95% confidence interval [CI]: 1.1–1417.3), HAART non‑adherence (aOR125.5; 95% CI: 9.6–1636.3), baseline CD4 <200cells/µl (aOR31.0; 95%CI: 1.6–590.6), previous TB (aOR13.8; 95% CI: 2.0–94.1), and current hemoglobin <10 g/dl (aOR10.3; 95% CI: 1.1–99.2). Conclusion: Factors associated with prevalent TB were a lower social class, HAART non‑adherence, severe immunosuppression before HAART initiation, previous TB, and anemia post‑HAART. TB case finding should be intensified in these high‑risk groups.Keywords: Factors, Highly active antiretroviral therapy, Human immunodeficiency virus, Prevalent, Tuberculosi