Factors Predicting an Unfavorable Course in the Patients with TB/HIV Co-infection

The objective: to identify early factors of unfavorable course of TB/HIV co-infection in order to improve approaches to treatment of such patients.

Subjects and Methods. The study included 105 HIV-positive patients diagnosed with tuberculosis for the first time and M.tuberculosis (MTB) DNA was detected in a biological sample by a molecular genetic test. Patients were divided into two groups: a group with a favorable course of TB/HIV co-infection (78 people) and a group with an unfavorable course (27 people).

Results. Significant factors influencing the course of TB/HIV co-infection and easily assessible in each patient (levels of leukocyte (x), hemoglobin (y), albumin (z), and iron (w)) were identified. A discriminant model was developed representing formula D = -8.263-0.110x + 0.012y + 0.197z + 0.024w. The accuracy of the model is 83.3%. If this parameter D ≥ -0.301, then a patient has a low risk of an unfavorable course of the co-infection; if D < -0.301, a patient faces a high risk of an unfavorable course of TB/HIV co-infection. In case of an unfavorable prognosis, an extended molecular genetic testing of M. tuberculosis drug susceptibility will allow choosing an adequate anti-tuberculosis treatment regimen. If no data about M. tuberculosis are available, treatment regimens for drug-resistant tuberculosis should be used. 

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