TB-HIV Co-infection and Risk of Death, Loss to Follow Up, and Viral Load Suppression in Democratic Republic Of Congo

Presentation given at APHA Annual Meeting and Expo. Background: To provide efficient, equitable, patient-centered care to people living with HIV/AIDS (PLWH), this study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes among PLWH with TB coinfection compared to those without such coinfection. Methods: This quantitative study used data on 49,460 PLWH on ART from 241 HIV/AIDS clinics in two provinces of Democratic Republic of Congo, Haut-Katanga and Kinshasa. Chi-square and logistic regression analysis were performed. Results: TB coinfection existed in 3.6% of the patients. Significantly higher proportions of patients with TB/HIV coinfection were males (4.5% vs. 3.3%); new patients rather than transferred-in (3.7% vs. 1.6%) resided in the Kinshasa province rather than Haut-Katanga (4.0% vs. 2.7%) and were in an urban health zone (3.9%) and semi-rural (3.1%) rather than rural (1.2%) health zone. The logistic regression models showed that after controlling for other demographic and clinical variables, TB/HIV coinfection raised the risk of death (AOR, 2.26; CI, 1.94 to 2.64) and loss to follow up (AOR, 2.06; CI, 1.82 to 2.34). TB/HIV coinfection lowered the odds of viral load suppression below 1,000 copies per ml of blood (AOR, 0.58; CI, 0.46 TO 0.74). Conclusions: TB/HIV coinfection raises the risk of negative outcomes. HIV clinics in DRC and other African countries may consider these findings when customizing their interventions to improve HIV care and reduce disparities in PLWH