Prevalencia y caracterización de la coinfección por el virus de la inmunodeficiencia humana en pacientes hospitalizados con tuberculosis en un hospital de referencia de Bogotá

Introduction. Tuberculosis is the leading cause of death in patients with human immunodeficiency virus infection; tuberculosis-HIV coinfection is highly prevalent.Objective. To establish the prevalence of HIV infection in patients hospitalized with tuberculosis and determine their characteristics and outcomes.Materials and methods. We conducted a retrospective cross-sectional study in patients diagnosed with pulmonary or extrapulmonary tuberculosis and HIV coinfection, hospitalized in a referral institution in Bogotá between 2019 and 2021.Results. The prevalence of HIV infection in 102 patients with tuberculosis was 52.3% (54/102). Among them, 24 patients (44.4%) had microbiological or histopathological confirmation of tuberculosis infection; and 19 (35.2%) were recently diagnosed with an HIV infection. The median age of the 54 coinfected patients was 38 years (IQR: 29-42); 79.6% (43/54) were men. The median CD4+ T-cell count was 59 cells/μL (IQR: 32-120), and 72.2% (39/54) had a CD4+ count of less than 200 cells/μL; 31.4% (17/54) of patients with a history of HIV infection were receiving antiretroviral therapy. Regarding tuberculosis clinical presentation, 51.9% (28/54) had pulmonary tuberculosis, and 48.1% (26/54) hadextrapulmonary tuberculosis. The extrapulmonary tuberculosis forms were meningeal (29.6%), miliary (12.9%), pleural (3.7%), and peritoneal (3.7%). The in-hospital mortality was 33.3%, associated with a low CD4+ count (p < 0.05), recent HIV diagnosis (p < 0.04), and the presence of meningeal tuberculosis (p < 0.03).Conclusion. The frequency of tuberculosis-HIV coinfection is high and related to an advanced degree of immunosuppression. Therefore, we recommend an active search for coinfection. Meningeal tuberculosis was the most frequent extrapulmonary form and was associated with mortality.