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Open Access Research article

Risk and prognostic significance of tuberculosis in patients from The TREAT Asia HIV Observational Database

Jialun Zhou1*, Julian Elliott1, Patrick CK Li2, Poh Lian Lim3, Sasisopin Kiertiburanakul4, Nagalingeswaran Kumarasamy5, Tuti Parwati Merati6, Sanjay Pujari7, Yi-Ming A Chen8, Praphan Phanuphak9, Saphonn Vonthanak10, Thira Sirisanthana11, Somnuek Sungkanuparph4, Christopher KC Lee12, Adeeba Kamarulzaman13, Shinichi Oka14, Fujie Zhang15, Goa Tau16 and Rossana Ditangco17

Author Affiliations

1 National Centre in HIV Epidemiology and Clinical Research The University of New South Wales, Sydney, Australia

2 Department of Medicine, Queen Elizabeth Hospital, Hong Kong, PR China

3 Tan Tock Seng Hospital, Singapore

4 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

5 YRG Centre for AIDS Research and Education, Chennai, India

6 School of Medicine Udayana University & Sanglah Hospital, Denpasar, Bali, Indonesia

7 Institute of Infectious Diseases, Pune, India

8 Taipei Veterans General Hospital and AIDS Prevention and Research Centre, National Yang-Ming University, Taipei, Taiwan

9 HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand

10 National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia

11 Research Institute for Health Sciences, Chiang Mai, Thailand

12 Hospital Sungai Buloh, Kuala Lumpur, Malaysia

13 University of Malaya, Kuala Lumpur, Malaysia

14 International Medical Centre of Japan, Tokyo, Japan

15 Beijing Ditan Hospital, Beijing, PR China

16 Port Moresby General Hospital, Port Moresby, Papua New Guinea

17 Research Institute for Tropical Medicine, Manila, the Philippines

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BMC Infectious Diseases 2009, 9:46  doi:10.1186/1471-2334-9-46

Published: 21 April 2009



To assess the risk and the prognostic significance of tuberculosis (TB) diagnosis in patients from The TREAT Asia HIV Observational Database, a multi-centre prospective cohort of HIV-infected patients receiving HIV care in the Asia-Pacific region.


The risk of TB diagnosis after recruitment was assessed in patients with prospective follow-up. TB diagnosis was fitted as a time-dependent variable in assessing overall survival.


At baseline, 22% of patients were diagnosed with TB. TB incidence was 1.98 per 100 person-years during follow up, with predictors including younger age, lower recent CD4 count, duration of antiretroviral treatment, and living in high TB burden countries. Among 3279 patients during 6968 person-years, 142 died (2.04 per 100 person-years). Compared to patients with CDC category A or B illness only, mortality was marginally higher in patients with single Non-TB AIDS defining illness (ADI), or TB only (adjusted HR 1.35, p = 0.173) and highest in patients with multiple non-TB AIDS or both TB and other ADI (adjusted HR 2.21, p < 0.001).


The risk of TB diagnosis was associated with increasing immunodeficiency and partly reduced by antiretroviral treatment. The prognosis of developing TB appeared to be similar to that following a diagnosis of other non-TB ADI.