ArticlemedRxiv : the preprint server for health sciences2025
HIV Remains a Risk Factor for Unfavorable Tuberculosis Treatment Outcomes in the Era of Universal Access to Antiretroviral Therapy in Botswana.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Botswana implemented its universal "Treat All" antiretroviral therapy (ART) policy in 2016, expanding treatment eligibility to all people living with HIV (PLHIV). HIV has been known to be a leading risk factor for tuberculosis (TB) and poor TB treatment outcomes. The primary goal of this study is to assess whether HIV infection and HIV-associated immunosuppression remain risk factors for unfavorable TB treatment outcomes in the Post-Treat All era. We analyzed 636 TB patients treated in Gaborone (2017-2023), of whom 54.4% were HIV-positive. Unfavorable outcomes (death, failure, or loss to follow-up) occurred in 19.7% of HIV-positive and 8.5% of HIV-negative patients. We used logistic regression to estimate unadjusted and covariate-adjusted associations between TB treatment outcome and HIV status and between TB treatment outcome and CD4+ T-cell count. HIV-positive patients had 2.5-fold higher odds of unfavorable outcomes compared with HIV-negative patients [adjusted OR: 2.51, 95% CI: (1.48, 4.38)], controlling for age, sex, TB history, distance to clinic, substance use, and occupational status. PLHIV with CD4+ T-cell <
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