• 1 The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
  • 2 Queen Elizabeth Hospital, Hong Kong, SAR China
  • 3 National Hospital for Tropical Diseases, Hanoi, Viet Nam
  • 4 Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
  • 5 Bach Mai Hospital, Hanoi, Viet Nam
  • 6 Research Institute for Tropical Medicine, Manila, The Philippines
  • 7 Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • 8 Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 9 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 10 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
  • 11 HIV-Netherlands Australia Thailand Research Collaboration, The Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 12 Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
  • 13 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 14 Taipei Veterans General Hospital, Taipei, Taiwan
  • 15 Therapeutics Research, Education, and AIDS Training in Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
Int. J. Tuberc. Lung Dis., 2018 02 01;22(2):179-186.
PMID: 29506614 DOI: 10.5588/ijtld.17.0348


SETTING: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background.

OBJECTIVE: To assess the socio-economic determinants of TB in HIV-infected patients in Asia.

DESIGN: This was a matched case-control study. HIV-positive, TB-positive cases were matched to HIV-positive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis.

RESULTS: A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50-13.17, P = 0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis.

CONCLUSIONS: These data suggest that lower socio-economic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.