Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

Sci Rep. 2020 Sep 22;10(1):15442. doi: 10.1038/s41598-020-71784-3.


Tuberculosis (TB) misdiagnosis remains a public health concern, especially among people living with HIV (PLHIV), given the high mortality associated with missed TB diagnoses. The main objective of this study was to describe the all-cause mortality, TB incidence rates and their associated risk factors in a cohort of PLHIV with presumptive TB in whom TB was initially ruled out. We retrospectively followed a cohort of PLHIV with presumptive TB over a 2 year-period in a rural district in Southern Mozambique. During the study period 382 PLHIV were followed-up. Mortality rate was 6.8/100 person-years (PYs) (95% CI 5.2-9.2) and TB incidence rate was 5.4/100 PYs (95% CI 3.9-7.5). Thirty-six percent of deaths and 43% of TB incident cases occurred in the first 12 months of the follow up. Mortality and TB incidence rates in the 2-year period after TB was initially ruled out was very high. The TB diagnostic work-up and linkage to HIV care should be strengthened to decrease TB burden and all-cause mortality among PLHIV with presumptive TB.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Coinfection / epidemiology
  • Coinfection / mortality*
  • Coinfection / virology
  • Female
  • HIV / isolation & purification*
  • HIV Infections / epidemiology
  • HIV Infections / mortality*
  • HIV Infections / virology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mozambique / epidemiology
  • Mycobacterium tuberculosis / isolation & purification*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tuberculosis / epidemiology
  • Tuberculosis / mortality*
  • Tuberculosis / virology