Abstract
OBJECTIVE: To identify the incidence of tuberculosis (TB) in people living with the human immunodeficiency virus (HIV) (PLWH) followed at an HIV referral and care facility.
DESIGN: Observational longitudinal cohort.
METHODS: Data were collected longitudinally as patients were admitted to the HIV programme and included demographics, TB diagnosis and treatment, CD4+ T lymphocyte count and TB treatment outcomes. The TB-free follow-up period of all patients was used to calculate TB incidence rates.
RESULTS: Between 1997 and 2007, 217 new adult patients joined the HIV programme. TB was diagnosed in 16 patients (7.4%), all of whom had acquired immune-deficiency syndrome at the time of TB diagnosis. Seven developed extra-pulmonary disease (44%), six had pulmonary TB (37%), while three had both (19%). The TB incidence rate was 1354 per 100 000 person-years (py) among the HIV-infected cohort. The incidence rate of pulmonary TB was 762/100 000 py and for extra-pulmonary TB it was 592/100 000 py. Seven patients (44%) died despite early diagnosis and treatment for TB.
CONCLUSION: Among PLWH in Saudi Arabia, TB incidence is 30 times higher than in the general population, with significant mortality despite early diagnosis, treatment and tertiary care support.