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Table 1 Baseline characteristics of the TB:HIV patients in Eastern Europe stratified by delayed diagnosis and factors associated with delayed diagnosis

From: Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

  Total Delayed diagnosis OR (95% CI) p-value Adjusted OR (95% CI) p-value
< 1 month ≥ 1 month
n = 740 n = 260 n = 480     
Gender
 Male 563 (76.1) 200 (76.9) 363 (75.6) 0.93 (0.65–1.33) 0.69   
Age
 Age 16–49 694 (93.8) 250 (96.2) 444 (92.5) Ref Ref Ref Ref
 Age ≥ 50 46 (6.2) 10 (3.8) 36 (7.5) 2.62 (1.21–5.66) 0.01 2.51 (1.18–5.32) 0.016
Exposure group (HIV)
 MSM (yes vs no) 10 (1.4) 5 (1.9) 5 (1.0) 0.54 (0.15–1.87) 0.32   
 IDU (yes vs no) 422 (57.0) 132 (50.8) 290 (60.4) 1.48 (1.09–2.00) 0.01 1.66 (1.21–2.29) 0.002
 Heterosexual (yes vs no) 183 (24.7) 72 (27.7) 111 (23.1) 0.79 (0.56–1.11) 0.17   
Known HIV at TB diagnosis 668 (90.3) 235 (90.4) 433 (90.2) 0.98 (0.59–1.63) 0.94   
Treatment history (HIV)
 ART naïve at TB diagnosisa 558 (75.4) 176 (67.7) 382 (79.6) 1.86 (1.32–2.63) 0.0001 1.77 (1.24–2.54) 0.002
 ART use at TB diagnosisa 132 (17.8) 59 (22.7) 73 (15.2) 0.61 (0.42 –0.9) 0.011 Omittedd  
 Cotrimoxazole at TB diagnosis 273 (36.9) 84 (32.3) 189 (39.4) 1.36 (0.99–1.87) 0.057 1.25 (0.89–1.74) 0.197
CD4-cell count/mm3°
 0–199/mm3 440 (59.5) 151 (58.1) 289 (70.8) 1.06 (0.74–1.52) 0.745   
 ≥ 200 185 (25.0) 66 (25.4) 119 (29.2) Ref Ref   
 Missing CD4 115 (15.5) 43 (37.4) 72 (62.6) 0.93 (0.57–1.51) 0.764   
Prior AIDS 177 (23.9) 66 (25.4) 111 (23.1) 0.88 (0.62–1.26) 0.49   
Previous TB
 Yes vs no 99 (13.4) 46 (17.7) 53 (11.0) 0.58 (0.38–0.89) 0.011 0.60 (0.38–0.95) 0.029
TB risk factor
 Alcohol abuse (yes vs no) 186 (25.1) 72 (27.7) 114 (23.8) 0.81 (0.58–1.15) 0.24   
 Recent TB in family (yes vs no) 53 (7.2) 17 (6.5) 36 (7.5) 1.16 (0.64–2.11) 0.63   
 Imprisonment within 2 years (yes vs no) 143 (19.3) 47 (18.1) 96 (20.0) 1.13 (0.77–1.67) 0.53   
Clinical presentation of TB
 Pulmonary (including trachea and larynx) 239 (32.3) 101 (38.9) 138 (28.8) Ref Ref Ref Ref
 Extrapulmonary 54 (7.3) 23 (8.9) 31 (6.5) 0.99 (0.54–1.79) 0.964 0.83 (0.44–1.55) 0.553
 Disseminated 447 (60.4) 136 (52.3) 311 (64.8) 1.67 (1.21–2.32) 0.002 1.56 (1.10–2.19) 0.012
Localisations TB was found (non-exclusive)
 Pulmonary (including trachea and larynx) 654 (88.4) 227 (87.3) 427 (89.0) 1.17 (0.74–1.86) 0.504 Omittede  
 Pleural 92 (12.4) 32 (12.3) 60 (12.5) 1.02 (0.64–1.61) 0.94 Omittede  
 Lymphatic 309 (41.8) 76 (29.2) 233 (48.5) 2.28 (1.65–3.17) 0.0001 Omittede  
 Bone and/or joint 13 (1.8) 2 (0.8) 11 (2.3) 3.03 (0.66–13.8) 0.155 Omittede  
 Genitourinary 37 (5.0) 5 (1.9) 32 (6.7) 3.64 (1.39–9.52) 0.004 Omittede  
 Meningeal and other central nervous system 74 (10.0) 28 (10.8) 46 (9.6) 0.88 (0.53–1.44) 0.608 Omittede  
 Gastro-intestinal 55 (7.4) 16 (6.2) 39 (8.1) 1.35 (0.74–2.46) 0.329 Omittede  
TB symptoms
 Cough (yes vs no) 501 (67.7) 188 (72.3) 313 (65.2) 0.72 (0.52–0.99) 0.049 0.72 (0.51–1.02) 0.061
 Fever (yes vs no) 636 (86.0) 227 (87.3) 409 (85.2) 0.84 (0.54–1.31) 0.433   
 Weight loss (yes vs no) 445 (60.1) 133 (51.2) 312 (65.0) 1.77 (1.3–2.42) 0.0001 1.63 (1.18–2.24) 0.003
Number of symptomsc
 None 20 (2.7) 6 (2.3) 14 (2.9) Ref Ref   
 One symptom 133 (18.0) 50 (19.2) 83 (17.3) 0.71 (0.26–1.97) 0.512   
 Two symptoms 312 (42.2) 114 (43.9) 198 (41.3) 0.74 (0.28–2.0) 0.556   
 Three symptoms 275 (37.2) 90 (34.6) 185 (38.5) 0.88 (0.33–2.37) 0.802   
Screening chest X-ray before current episode
 Yes vs no 338 (45.7) 115 (44.2) 223 (46.5) 1.09 (0.81–1.48) 0.56   
Rifampicin resistance
 Yes vs no 95 (38.3) 34 (35.8) 61 (39.9) 1.19 (0.7–2.0) 0.52   
MDR-TB
 Yes 88 (11.9) 31 (11.9) 57 (11.9) 1.22 (0.71–2.11) 0.478   
 No 148 (20.0) 59 (22.7) 89 (18.5) Ref Ref   
 Missing drug susceptibility testing 504 (68.1) 170 (65.4) 334 (69.6) 1.30 (1.09–1.90) 0.170   
Diagnosis
 Definite 333 (45.0) 123 (47.3) 210 (43.8) Ref Ref   
 Probable 76 (10.3) 24 (9.2) 52 (10.8) 1.27 (0.75–2.16) 0.380   
 Presumptive 331 (44.7) 113 (43.5) 218 (45.4) 1.13 (0.82–1.55) 0.451   
Hepatitis B
 HbsAg at baselineb 44 (6.0) 17 (6.5) 27 (5.6) 0.85 (0.46–1.59) 0.616   
Hepatitis C
 Anti-HCV antibodiesb 405 (54.7) 134 (51.5) 271 (56.5) 1.21 (0.9–1.65) 0.199   
Continuous variables
 Weight (kg)
  Baseline 60 (53–68) 63 (55–68.5) 60 (53–68) 0.99 (0.97–1.01) 0.255   
 HIV-RNA (log10) copies/ml
  Baseline 5.3 (4.5–5.8) 5.2 (4.3–5.7) 5.3 (4.6–5.8) 1.12 (0.96–1.32) 0.158   
  1. Adjusted for age, IDU, ART treatment naivety, cotrimoxazole treatment, previous TB, clinical TB presentation and TB symptoms cough and weight loss
  2. OR odds ratio, CI confidence interval, MSM Men Who Have Sex with Men, IDU injecting drug use
  3. aThose not included in the categories “ART naïve at TB diagnosis” and”ART use at TB diagnosis” have previously received ART and interrupted their treatment
  4. bThose with missing information for chest x-ray (n = 278), HBsAg (n = 215), Anti-HCV (n = 220) assumed negative
  5. cIndex based on symptoms cough, fever, weight loss
  6. dOmitted because of multicollinearity with Treatment Naivety (correlation co-efficient 0.7817)
  7. eOmitted in model as part of extra-pulmonary/disseminated