Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB

BACKGROUND: Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with...

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Main Authors: N. Hernandez-Morfin, S. Cohn, Z. Waja, R.E. Chaisson, N. Martinson, N. Salazar-Austin
Format: Article
Language:English
Published: The Union 2025-03-01
Series:Public Health Action
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Online Access:https://www.ingentaconnect.com/contentone/iuatld/pha/2025/00000015/00000001/art00007
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author N. Hernandez-Morfin
S. Cohn
Z. Waja
R.E. Chaisson
N. Martinson
N. Salazar-Austin
author_facet N. Hernandez-Morfin
S. Cohn
Z. Waja
R.E. Chaisson
N. Martinson
N. Salazar-Austin
author_sort N. Hernandez-Morfin
collection DOAJ
description BACKGROUND: Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with HIV (PWLHIV) and diagnosed with TB in the Tshepiso study. METHODS: In this secondary analysis, we used multivariable logistic regression to evaluate factors associated with unsuccessful TB treatment outcomes among PWLHIV with drug-sensitive TB disease enrolled in the Tshepiso study in Soweto, South Africa, from 2011–2014. RESULTS: This analysis includes 79 PWLHIV diagnosed with drug-sensitive TB during pregnancy; 18 (23%) had an unsuccessful treatment outcome. Factors associated with unsuccessful TB treatment include detectable HIV RNA viral load at enrollment to the study (aOR 5.1, 95% CI 1.1–25.3), presence of extrapulmonary TB (aOR 2.2, 95% CI 0.4–11.7), bacteriological (positive smear and/or culture) confirmation of TB (aOR 2.1, 95% CI 0.7–6.7), and anemia (Hb ≤ 10.5 g/dL) (aOR 1.0, 95% CI 0.3–3.1). The only factor with statistical significance was a detectable HIV RNA viral load. CONCLUSION: Detectable HIV viral load emerges as a critical factor associated with an unsuccessful TB treatment outcome in pregnant women living with HIV and diagnosed with TB.
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spelling doaj-art-d20c59e4ab0b4675b05bc6d894fba0e22025-08-20T03:00:27ZengThe UnionPublic Health Action2220-83722025-03-01151333710.5588/pha.24.00517Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TBN. Hernandez-Morfin0S. Cohn1Z. Waja2R.E. Chaisson3N. Martinson4N. Salazar-Austin5Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA;BACKGROUND: Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with HIV (PWLHIV) and diagnosed with TB in the Tshepiso study. METHODS: In this secondary analysis, we used multivariable logistic regression to evaluate factors associated with unsuccessful TB treatment outcomes among PWLHIV with drug-sensitive TB disease enrolled in the Tshepiso study in Soweto, South Africa, from 2011–2014. RESULTS: This analysis includes 79 PWLHIV diagnosed with drug-sensitive TB during pregnancy; 18 (23%) had an unsuccessful treatment outcome. Factors associated with unsuccessful TB treatment include detectable HIV RNA viral load at enrollment to the study (aOR 5.1, 95% CI 1.1–25.3), presence of extrapulmonary TB (aOR 2.2, 95% CI 0.4–11.7), bacteriological (positive smear and/or culture) confirmation of TB (aOR 2.1, 95% CI 0.7–6.7), and anemia (Hb ≤ 10.5 g/dL) (aOR 1.0, 95% CI 0.3–3.1). The only factor with statistical significance was a detectable HIV RNA viral load. CONCLUSION: Detectable HIV viral load emerges as a critical factor associated with an unsuccessful TB treatment outcome in pregnant women living with HIV and diagnosed with TB.https://www.ingentaconnect.com/contentone/iuatld/pha/2025/00000015/00000001/art00007pregnancymaternal healthtuberculosistb-hiv co-infectiontbtreatment outcomes
spellingShingle N. Hernandez-Morfin
S. Cohn
Z. Waja
R.E. Chaisson
N. Martinson
N. Salazar-Austin
Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
Public Health Action
pregnancy
maternal health
tuberculosis
tb-hiv co-infection
tb
treatment outcomes
title Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
title_full Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
title_fullStr Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
title_full_unstemmed Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
title_short Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB
title_sort assessing tb treatment outcomes in pregnant women living with hiv with drug susceptible tb
topic pregnancy
maternal health
tuberculosis
tb-hiv co-infection
tb
treatment outcomes
url https://www.ingentaconnect.com/contentone/iuatld/pha/2025/00000015/00000001/art00007
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