Background: Indonesia is the world’s fourth highest tuberculosis (TB) burden in the world. TB is the second leading cause of death for all age in the country. Mortality rate remains high among hospitalized TB patients compared to the non-TB patients. The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). TB is the leading killer of HIV-infected individuals worldwide.
Objective: To describe the characteristics and to determine mortality rate among hospitalized HIV-infected patients with TB in Cipto Mangunkusumo Hospital (CMH), Jakarta, Indonesia.
Methods: A retrospective cohort study was performed among hospitalized TB/HIV patients in CMH between January 2008 and September 2013. Data were collected at initiation of inpatients period and the main outcome was all-cause mortality during hospitalization. Analyzed factors included age, sex, history of previous anti-TB treatment, sputum smear positivity, hypoalbuminemia, BMI, pulmonary radiographic lesion and comorbidity (CCI score). Data were analyzed using Chi-square test or Fischer test.
Results: A total of 191 TB/HIV patients were evaluated in this study. There were 157 (82.6%) male and 34 (17.4%) female patients. Median age was 31 (range 20 to 71) years old and median length of stay was 11 (range 1 to 57) days. In-hospital mortality rate was 29,8%. One hundred and thirty patients had CD4 count data, and 128 (98,5%) of them had CD4<200 cell/uL. Factorsassociated with in-hospital mortality were history of previous TB treatment, (p=0,001), hypoalbuminemia (p<0,001) and cavitary lesion in chest radiographic (p<0,001).
Conclusion: In-hospital mortality rate was 29,8%. The majority of TB/HIV patients had low CD4 count (<200cell/ uL). Factors associated with in hospital mortality were history of previous TB treatment, hypoalbuminemia and cavitary lesion in chest radiographic.
Key words: Tuberculosis, HIV positive, in-hospital mortality