• KETUT SURYANA Department of Internal Medicine at Wangaya Hospital in Denpasar, Bali, Indonesia
  • HAMONG SUHARSONO Department of Biochemistry, Veterinary Faculty of Udayana University, in Denpasar, Bali, Indonesia
  • NOVIANA JOENPUTRI General Practitioner, Department of Internal Medicine at Wangaya Hospital in Denpasar, Bali, Indonesia


Objective: To estimate the Pulmonary Tuberculosis (PTB) prevalence among the participants/People Living With HIV/AIDS (PLWHAs) and to verify the association between WHO clinical staging and other risk factors with PTB.

Methods: A cross-sectional study was conducted to estimate the PTB prevalence. Probable associated risk factors in PLWHAs with and without PTB were compared. The association between WHO clinical staging and other risk factors with PTB was investigated using bivariate analysis. A p-value<0.05 was considered statistically significant.

Results: This study was conducted from January 2018 to December 2019, recruited about 584 participants with presumptive PTB and 20.72% (121) confirmed with PTB. In the bivariate analysis; participants who are on human immunodeficiency virus (HIV) Stage 4 (WHO clinical staging) were significantly more likely to develop PTB (p=0.000). PTB was significantly higher among male than female (p=0.000), higher among the older (p=0.030). PTB was significantly more frequent among participants with lower cluster differentiation 4 (CD4) cell counts (p=0.042). A contact history with a Tuberculosis (TB) patient was an important risk factor (p=0.000). PTB was significantly associated with smoking history (p=0.000).

Conclusion: A high PTB prevalence was observed. There was a significantly association between the severity of WHO clinical staging, sex, age, lower CD4 cell count, a contact history with a tuberculosis (TB) patient and smoking history with PTB among PLWHAs.

Keywords: PLWHAs, WHO clinical staging, Associated risk factors, PTB


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Author Biography

HAMONG SUHARSONO, Department of Biochemistry, Veterinary Faculty of Udayana University, in Denpasar, Bali, Indonesia

Department of Biochemistry, Veterinary Faculty of Udayana University in Denpasar, Bali, Indonesia


1. Karo B, Haas W, Kollan C, Gunsenheimer-Bartmeyer B, Hamouda O, Fiebig L, et al. tuberculosis among people living with HIV/AIDS in the german clin surv HIV cohort: long-term incidence and risk factors. BMC Infect Dis 2014;14:1-12.
2. Ali A, Ahmad F, Imran M, Atif M, Noor Y, Imran S, et al. Prevalence of pulmonary tuberculosis in HIV/AIDS subjects. Austin Virol Retrovirol 2016;3:1023-5.
3. Ramamurthy K, Bhat S, Shenoy S, Rangnekar A. Xpert mycobacterium tuberculosis/rifampicin assay: a boon in tuberculosis diagnostics. Asian J Pharm Clin Res 2016;9:225-7.
4. Cui Z, Lin M, Nie S, Lan R. Risk factors associated with tuberculosis (TB) among people living with HIV/AIDS: a pair-matched case-control study in Guangxi, China. PLoS One 2017;12:1-12.
5. Sawant DV, Desai MM, Patil RS, Pawar SH. Evolution of nantotech assisted PCR diagnosis of mycobacterium tuberculosis and its assessment with conventional methods. Int J Pharm Pharm Sci 2018;10:133-7.
6. Swaminathan S, Narendran G. HIV and tuberculosis in India. J Biosci 2008;33:527-37.
7. Mahtab S, Coetzee D. Influence of HIV and other risk factors on tuberculosis. South Afr Med J 2017;107:428-34.
8. Taha M, Deribew A, Tessema F, Assegid S, Duchateau L, Colebunders R. Risk factors of active tuberculosis in people living with HIV/AIDS in Southwest Ethiopia: a case-control study. Ethiop J Health Sci 2011;21:131-9.
9. WHO. Treatment of tuberculosis guidelines. 4th ed.; 2010. Available from: http/ 9789241547833/en/. [Last accessed 04 Apr 2016].
10. Wolrd Health Organization. Interim WHO clinical staging of HIV/AIS amd HIV/AIDS case definitions for surveillance. African Region; 2005.
11. Narasimhan P, Wood J, MacIntyre CR, Mathai D. Risk factors for tuberculosis: review article. Pulmonary Medicine 2013;1-11.
12. Mama M, Manilal A, Tesfa H, Mohammed H, Erbo E. Prevalence of pulmonary tuberculosis and associated factors among HIV positive patients attending antiretroviral therapy clinic at Arba Minch General Hospital, Southern Ethiophia. Open Microbiol J 2018;12:163-71.
13. Negussie A, Debalke D, Belachew T, Tadesse F. Tuberculosis co-infection and its associated factors among people living with HIV/AIDS attending antiretroviral therapy clinic in souther Ethiophia: a facility-based retrospective study. BMC REs Notes 2018;11:417.
14. Tiwari BR, Karki S, Ghimire P, Sharma B, Malla S. Factors associated with high prevalence of pulmonary tuberculosis in HIV-infected people visiting for assessment of eligibility for highly active antiretroviral therapy in Kathmandu, Nepal. WHO South-East Asia J Public Heal 2012;1:404-11.
15. Kibret KT, Yalew AW, Belaineh BG, Asres MM. Determinant factors associated with occurrence of tuberculosis among adult people living with HIV after antiretroviral treatment initiation in addis ababa, ethiopia: a case control study. PLoS One 2013;8:1-8.
16. Belay A, Alamrew Z, Be Y, Tegegne B, Tiruneh G, Feleke A. Magnitude and correlates of tuberculosis among HIV patients at felege hiwot referral hospital, bahir dar city, northwest ethiopia. Clin Med Res 2013;2:77-83.
17. Roselinda, Setiawaty V. The stages of HIV infection and the risk of opportunistic tuberculosis infection. Health Sci J Indonesia 2015;6:121-5.
18. Awadalla H, El-Samani F, Soghaier MA, Makki M. Risk factors with the development of tuebrculosis among HIV-infected patients in Khartoum in 2010. AIMS Public Health 2010;2:784-92.
19. Tesfaye B, Alebel A, Gebrie A, Zegeye A, TEsema C, Kassie B. The twin epidemics: prevalence of TB/HIV co-infection and its associated factors in Ethiophia; a systematic review and meta-analysis. PLos One 2018;13:e0203986.
20. Carvalho BMD, Monteiro AJ, Nefro RDJP, Grangeiro TB, Frota CC. Factors related to HIV/uberculosis coinfection in brazilian reference hospital. Br J Infectious Disease 2008;12:281-6.
21. Boum Y, Atwine D, Orikiriza P, Assimwe J, Page AL, Mwanga Amumpaire J, et al. Male gender is independently associated with pulmonary tuberculosis among sputum and non-sputum producers people with presumptive tuberculosis in Southwestern Uganda. BMC Infect Dis 2014;14:1–8.
22. Horton KC, MacPherson P, Houben RMGJ, White RG, Corbett EL. Sex differences in tuberculosis burden and notifications in low-and middle-income counts: a systematic review and meta-analysis. PLoS Med 2016;13:1–23.
23. Dovonou A, Kpangon A, Amidou S, Dansou S, Attinssounon C, Keke R, et al. Risk factors for pulmonary tuberculosis treatment failure in rural settings in Benin, West Africa: a cohort study. Afr J Respir Med 2017;12:1-4.
24. Keizer ST, Langendam MMW, Van Deutekom H, Coutinho RA, Van Ameijden EJC. How does tuberculosis relate to HIV positive and HIV negative drug users? J Epidemiol Community Health 2000;54:64–8.
25. Ghaffari Fam S, Hosseini SR, Heydari H, Vaseghi Amiri R, Daemi A, Sarbazi E, et al. Epidemiological patterns of tuberculosis disease in the Babol, Iran. J Anal Res Clin Med 2015;3:164–9.
26. Chang CA, Meloni ST, Eisen G, Chaplin B, Akande P, Okonkwo P, et al. Tuberculosis incidence and risk factors among human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy in a large HIV program in nigeria. Open Forum Infect Dis 2015;2:1–11.
27. Sutariya SB, Shah HM, Patel DA, Dandge VA. Tuberculosis in patients living with HIV/AIDS: types and its relation to CD4 count. Natl J Med Res 2015;5:75-8.
28. Sudre P, Hirschel B, Toscani L, Ledergerber B, der HL. Risk factors for tuberculosis among HIV-infected patients in switzerland. Eur Respir J 1996;9:279-83.
29. Ellis PK, Martin WJ, Dodd PJ. CD4 count and tuberculosis risk in HIV-positive adults not on ART: a systematic review and meta-analysis. Peer J 2017;5:1-15.
30. Swarna NY. A review of tuberculosis research in malaysia. Med J Malaysia 2014;69:88-102.
31. Gjergji M, Bushati J, Harxhi A, Hafizi H, Pipero P. Tuberculosis in HIV/AIDS patients. Biom Biostat Int 2018;7:432-7.
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How to Cite
SURYANA, K., H. SUHARSONO, and N. JOENPUTRI. “THE THE ASSOCIATION BETWEEN WHO CLINICAL STAGE AND OTHER RISK FACTORS WITH PULMONARY TUBERCULOSIS AMONG PEOPLE LIVING WITH HIV/AIDS: A CROSS-SECTIONAL STUDY”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 12, no. 7, July 2020, pp. 18-22, doi:10.22159/ijpps.2020v12i7.37982.
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