Risk Factors for the Development of Tuberculosis Among HIV-Positive Adults Under Highly Active Antiretroviral Therapy at Government Hospitals in Amhara Region, Ethiopia

BACKGROUND: Tuberculosis is one of the leading infectious diseases for people living with HIV. Therefore, the purpose of this study was to investigate factors affecting the development of TB among HIV-positive adults under treatment in government hospitals of Amhara Region, Ethiopia. METHODS: A hospital-based retrospective study design was conducted among 700 HIV-positive adults under HAART in 17 government hospitals in the Amhara region, Ethiopia. RESULTS: Age of the patients (AOR = 1.122, 95% CI:1.013, 2.234), baseline CD4 cell count (AOR = 0.888, 95% CI: 0.714, 0.945), patients living without their partner (AOR = 1.212, 95% CI: 1.051, 1.123), females under treatment (AOR = 0.786, 95% CI; 0.564, 0.845), non-opportunistic diseases (AOR = 0.865, 95% CI: 0.731, 0.938), patients not disclosed their HIV status (AOR = 1.241, 95% CI: 1.087, 2.341), rural patients (AOR = 1.135, 95% CI: 1.032, 1.453, patient with no education (AOR = 1.125, 95% CI: 1.056, 1.546), low adherence patients (AOR = 1.225, 95% CI: 1.191, 2.453), bedridden patients (AOR = 1.223, 95% CI: 1.131, 1.521), ambulatory patients (AOR = 1.156, 95% CI:1.091, 1.267), non-smoker patients (AOR = 0.854, 95% CI: 0.686, 0.935) significantly affected on the variable of interest. Similarly, alcohol intake, drug toxicity and baseline clinical WHO stages significantly affected for the development of tuberculosis in HIV-positive patients under treatment. CONCLUSION: In this study, baseline CD4 cell count, female patients, non-opportunistic diseases, and non-smoking status were negatively associated with the development of TB, whereas age of patients, living without partners, patients with no education, patients with low adherence, bedridden and ambulatory patients were positively associated to the development of TB in HIV patients. The findings obtained in this study are important for both service providers and patients. More attention should be given to those positively associated variables to response variables. The regional health bureau should open TB/HIV co-infection subsections like ART sections in each hospital.