Tuberculosis Incidence Predictors And Tb Free Survival Among Hiv Infected Adults Who Completed Isoniazid Preventive Therapy In Hawassa Comprehensive Specialized Hospital Sidama Regional State Hawassa Ethiopia 2020

Background: Tuberculosis (TB) is the most frequent life threatening opportunistic disease and thernleading cause of death in HIV-infected people. At the same time, antiretroviral therapy (ART) is thernsingle most important way to reduce the incidence of TB in people living with the HIV infection.rnHowever, people with HIV on ART remain highly vulnerable to TB. Taking a six month course ofrnIsoniazide Preventive Therapy (IPT) is known to reduce the risk of TB in people with HIV andrnlatent TB by 32-64% for two to three years.rnObjectives: The aim of the study was to assess the incidence, predictors and TB free survival rnamong HIV/AIDS patients on ART who completed IPT in Hawassa Comprehensive SpecializedrnHospital.rnMethods: Five years Health institution based retrospective cohort study design was Conductedrnusing a checklist to gather data from 483 randomly selected Adult HIV patients charts. The datarnextraction tool was developed from the standardized ART entry and follow up form currently usedrnby the ART clinics based on WHO model. Data was cleared and entered into Epi-data V-4.62 andrnexported to SPSS V-25 for further statistical analysis. Data was analyzed by bivariate andrnmultivariable analysis using Cox regression proportional hazard model. Survival was calculated andrncompared with the Kaplan Meier and log rank test respectively.rn Results: A total of 483 HIV positive adults were studied. The median follow up time was 54rnmonths (IQR = 20–41.75). A total of 55 TB cases occurred in 1490 total PY of follow up. Thernoverall TB incidence was 3.7/100 PYO (95%CI; 2.6–2.8). Factors associated with TB incidencerninclude; being Female (AHR = 2.07, 95% CI; 0.78–5.26), WHO stage III and IV (AHR = 3.2, 95%rnCI; 1.15–8.95) and IV (AHR = 4.5, 95% CI; 0.19–1.094), Hgb 11 mg/dl (AHR= 3.17; 95%CI, 0.15 to7.01). Bedridden at baseline were 3.28rntimes at higher risk of developing TB (AHR 3.28; 95%CI, 0.134 to 8.06). Individuals whorncompleted IPT were 94% less likely to develop TB (AHR 0.60; 95%CI, 0.018 to 0.203). Viral loadrn1000 copies/ml (AHR=1.96; 95%CI,rn0.04 to 2.20). rnConclusion: Completion of IPT significantly reduced TB incidence by 94.0% and IPT hadrnsignificantly protected occurrence of active TB for five years among HIV infected patients.

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