Peculiarities of persons who inject drugs among patients with HIV–tuberculosis coinfection registered in 4^th District TB Unit Bucharest during 2009–2018

Introduction: Human immunodeficiency virus (HIV)–tuberculosis (TB) coinfection is a worldwide problem and a subject of concern, being associated with high mortality and risk of complications. Intravenous drug use is a way of getting infected with HIV that continues to rise, especially in the big cities. We aimed to study the peculiarities of persons with HIV–TB who inject drugs.

Methods: We performed a retrospective, observational study, among patients treated for TB in the 4^th District TB unit, Bucharest, during a 10-year period. A unique registry of patients with TB was used, and data of all patients with HIV–TB were noted ( demographics, medical, treatment outcome). A comparison between drug users (people who inject drugs [PWID]) and nondrug users (non-PWID) was assessed.

Results: We identified 122 patients with HIV–TB: 60 PWID, 58 non-PWID, and 4 former users. The mean age was 36.4 ± 9.8 years, 75% were males, and 73% were using antiretroviral treatment (ART). After comparing PWID with non-PWID patients, the following differences were noted: age (33.0 ± 6.0 years in PWID vs 40.5 ± 11.3 in non-PWID, P < 0.0001), gender (87% vs 66% males, P = 0.0034), presence of chronic hepatitis (97% vs 21%, P < 0.0001), CD4 number (156.1 ± 204.5 cells/mm³ vs 260.8 ± 248.9 cells/mm³, P = 0.0409), ART (65% vs 84%, P = 0.0075), and evaluation at the end of TB treatment (P = 0.0373).

Conclusions: PWID represent a vulnerable population of those with HIV–TB coinfection, whose outcome in TB treatment is significantly poorer and who are at risk of abandonment, death, and comorbidities. They should be included in dedicated programmes that are aimed at increasing adherence to treatment and care, additionally assessing the dependence problem.