Association of adverse outcomes in a tuberculosis hospital with HIV infection

Objective: To investigate the effect of regional HIV and tuberculosis incidence on the number of adverse outcomes in a tuberculosis hospital. Material and methods . This study is retrospective and non-randomized. The analysis includes data from the Russian Federal Service for Surveillance in Healthcare (Roszdravnadzor) on the incidence, prevalence, and mortality of HIV infection and tuberculosis in the Primorsky Krai region, as well as medical records of deceased patients from the tuberculosis hospital during the period from 2014 to 2023. Results . The epidemiological situation of tuberculosis in Primorsky Krai remains unstable and tense, representing one of the leading causes of death among the HIV-positive population and significantly affecting the mortality rate of HIV-infected patients. Correlation analysis assessing the strength of the associations between regional incidence and mortality from HIV infection in the tuberculosis hospital showed no significant association (p > 0.05), which, in our opinion, indicates a lack of influence of the tuberculosis service on the processes of timely detection, early diagnosis, and treatment of HIV patients. There is a direct correlation between the increase in adverse outcomes from surgical complications and the rising number of HIV-infected patients in the tuberculosis hospital (p < 0.05); moreover, adverse outcomes among HIV patients accounted for up to 35% of all deaths. Conclusion . No observed trend toward a decrease in HIV-related mortality exists in Primorsky Krai. The majority of adverse outcomes in the tuberculosis hospital among patients with HIVassociated infections are due to insufficient geographical coverage for case detection and timely diagnosis, as well as low adherence of the patient population to tuberculosis chemoprophylaxis