What question did this study set out to answer?

To identify risk factors associated with delayed tuberculosis diagnosis and evaluate its impact on mortality among people living with HIV.

October 6, 2021BMC Infectious DiseasesOpen Access

Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

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Authors

CKChristian KraefUniversity of Copenhagen ABAdrian BentzonUniversity of Copenhagen APAlexander PanteleevNovosibirsk Tuberculosis Research Institute

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Implication

Prospective cohort study reveals widespread delayed tuberculosis diagnosis among people with HIV, indicating a critical need to streamline diagnostic pathways to reduce mortality.

Key Points

To identify risk factors associated with delayed tuberculosis diagnosis and evaluate its impact on mortality among people living with HIV.
Multicentre prospective cohort study enrolling 740 people living with HIV diagnosed with tuberculosis across clinics in Eastern Europe with follow-up to 24 months.
Delayed diagnosis was defined as symptom duration (cough, weight loss, or fever) of 1 month or longer prior to diagnosis.
Risk factors were analyzed using multivariable logistic regression, and mortality was evaluated using Kaplan-Meier estimates and Cox proportional hazards models.
Delayed diagnosis occurred in 64.9% (480/740; 95% CI 61.3–68.3%) of participants.
Delayed diagnosis was significantly associated with age ≥ 50 years (aOR = 2.51; 95% CI 1.18–5.32; p = 0.016), injecting drug use (aOR = 1.66; 95% CI 1.21–2.29; p = 0.002), ART-naïve status (aOR = 1.77; 95% CI 1.24–2.54; p = 0.002), disseminated TB (aOR = 1.56; 95% CI 1.10–2.19; p = 0.012), and weight loss (aOR = 1.63; 95% CI 1.18–2.24; p = 0.003).
Delayed diagnosis correlated with an increased risk of death in unadjusted analysis (HR = 1.36; 95% CI 1.04–1.77; p = 0.023), though significance attenuated after adjustment (aHR = 1.27; 95% CI 0.95–1.70; p = 0.103).

Cite This Study

Kraef et al. (2021) studied this question.

synapsesocial.com/papers/6a8a948b238a34ecf472341e https://doi.org/10.1186/s12879-021-06745-w

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Implication

Prospective cohort study reveals widespread delayed tuberculosis diagnosis among people with HIV, indicating a critical need to streamline diagnostic pathways to reduce mortality.

Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Discussion

Member takes

Implication

Key Points

Cite This Study

Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Discussion

Member takes

Implication

Key Points

Cite This Study

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