Analysis of Incidence and associated factors of Tuberculosis (TB) Among People Living with HIV (PLHIV) Under Anti-retroviral Treatment at Bheri Hospital ART, Nepal

Abstract

Abstract

Objective: To analyze the incidence of tuberculosis (TB) and identify the

associated factors among people living with HIV (PLHIV) in order to provide

evidence-based insights for improving prevention, diagnosis, and management

strategies, ultimately reducing the dual burden of TB and HIV.

Background: Tuberculosis (TB) remains a major public health concern among

people living with HIV (PLHIV), as the synergistic relationship between the two

diseases exacerbates morbidity and mortality. This study examines the incidence and

associated factors of TB among PLHIV under antiretroviral therapy (ART) at Bheri

Hospital, Nepal, from October 2023 to October 2024.

Methods: A retrospective cross-sectional study was conducted, reviewing medical

records of 592 ART clients, including 312 males, 276 females, and 4 third-gender

individuals. From this population, 21 newly diagnosed TB cases were identified and

analyzed for demographic, clinical, and behavioral factors using statistical methods.

Results: Among the 21 TB cases, 62% were male, 72% belonged to the workingage group (14–49 years), and 29% were from the Muslim community. Pulmonary

TB accounted for 57% of cases, while extra-pulmonary TB comprised 43%. A

critical finding was that only 5% of individuals had completed isoniazid preventive

therapy (IPT), and the majority developed TB within the first year of ART initiation.

Conclusion: The study underscores the disproportionate burden of TB among men,

working-age adults, and specific communities, alongside gaps in preventive care.

Strengthening early TB screening, IPT implementation, and integrated TB-HIV

services is essential to reduce TB incidence and improve outcomes among PLHIV.