Background:
Diabetes mellitus (DM) and human immunodeficiency virus (HIV) are major risk factors for the development of active tuberculosis (TB) and unfavorable treatment outcomes. While the interaction between TB and these comorbidities has been studied in various settings, detailed data on the trilateral overlap of TB, dysglycemia (prediabetes and DM), and HIV in Brazil remain scarce. Larger studies are needed to better define the clinical presentation of patients facing multiple comorbidities.
Abstract:
Methods: This multicenter prospective study analyzed 1,162 culture-positive pulmonary TB cases from the RePORT-Brazil cohort (2015–2019) and 279,143 cases from the Brazilian national registry (SINAN). Dysglycemia was defined by glycated hemoglobin (HbA1c) levels. Logistic regression models tested associations between HIV, glycemic status, and clinical characteristics.
Results: In RePORT-Brazil, the prevalence of DM and prediabetes (PDM) was 23.7% and 37.8%, respectively. HIV prevalence was approximately 21% regardless of glycemic status. Aging was independently associated with dysglycemia in both cohorts. HIV infection was not associated with an increased risk of DM or PDM. TB-DM patients with HIV (TBDM-HIV) were more likely to be male and report higher tobacco and alcohol use, but showed a lower proportion of positive sputum smears and abnormal chest X-rays compared to those without HIV.
Conclusion: There is a high prevalence of dysglycemia among TB patients in Brazil, emphasizing the need for systematic screening. HIV infection does not appear to be a determinant of dysglycemia in this population but is associated with more frequent recreational drug use and paucibacillary sputum samples.
Keywords: dysglycemia, HIV infection, pulmonary tuberculosis, Mycobacterium tuberculosis, diabetes.
Clique aqui
- Data de Publicação: 21/01/2022
- Autores: María B. Arriaga, Mariana Araújo-Pereira, Beatriz Barreto-Duarte, Caio Sales, João Pedro Miguez-Pinto, Evelyn B. Nogueira, Betânia M. F. Nogueira, Michael S. Rocha, Alexandra B. Souza, Aline Benjamin, Jamile G. de Oliveira, Adriana S. R. Moreira, Artur T. L. Queiroz, Moreno M. S. Rodrigues, Renata Spener-Gomes, Marina C. Figueiredo, Betina Durovni, Solange Cavalcante, José R. Lapa-e-Silva, Afrânio L. Kristki, Marcelo Cordeiro-Santos, Timothy R. Sterling, Valéria C. Rolla, Bruno B. Andrade.
