Unsuccessful tuberculosis-treatment in HIV-positive patients and associated factors.

BACKGROUND: TB is one of the most deathly infections worldwide, affecting disproportionally people living with HIV (PLHIV). Furthermore, HIV co-infection is related to worse outcomes for TB patients, including lower treatment success. METHODS: Using surveillance records of all TB cases notified in Barcelona city from 2001 to 2021, we analyzed TB treatment success according to HIV status. Additionally, we explored potential social and health related and factors associated to unsuccessful treatment in PLHIV, using multiple regression analyses. RESULTS: Out of the 8406 new TB cases diagnosed during the study period, 9% were co-infected with HIV. According to our regression models, PLHIV were more frequently men, users of injected drugs (aOR=45.81; 95% CI (33.10-64.26)), had previously been treated for TB (aOR=1.77; 95% CI (1.30-2.40)) and had a lower rate of contact tracing (aOR=0.51; 95% CI (0.40-0.64)). Among PLHIV, unsuccessful treatment was related to the use of injected drugs and homelessness, but it was lower for those who had undergone contact tracing. CONCLUSION: PLHIV have higher odds of unsuccessful TB treatment, especially those who are homeless and use injected drugs. Contact tracing improved treatment success, calling for further efforts and resources to correctly follow-up on these patients, with the goal of increasing treatment success.