Factors predicting non-completion of tuberculosis treatment among HIV-infected patients in Barcelona (1987-1996)

OBJECTIVE: To determine the predictive factors of noncompletion of tubercul osis (TB) treatment among patients infected with the human immunodeficiency virus (HIV). DESIGN: Between 1987 and 1996, 2201 HIV-infected TB patients were detected by the Barcelona Tuberculosis Prevention and Control Programme, Patients wh o completed treatment were compared to those who abandoned. Bivariate analy sis was made by XL test to compare qualitative variables. Associations were measured by means of odds ratios (OR) with 95% confidence intervals (CI). Variables showing a statistically significant association were analysed at multivariate level by means of a logistic regression model. RESULTS: Treatment was carried to completion by 1065 patients (38.4%), 289 (13.1%) abandoned, 648 (29.5%) died during treatment, and 142 (6.5%) moved out of the city. Final outcome could not be established in 57 (2.5%). Intra venous drug users (IDU) represented 76.2% of patients. The rate of non-comp letion between 1987 and 1992 was 26.3% and for 1933-1996 it was 15.1%, a de crease of 42.6%. Living in neighbourhoods of a low socio-economic level (OR 1.61; 95%CI 1.22-2.13), homelessness (OR 3.56; 95%CI 2.01-6.31), history O f TB (OR 1.61; 95%CI 1.12-2.33), and having presented with a current TB epi sode in 1987-1992 (OR 1.42; 95%CI 1.01-2.00), were risk factors for abandon ing TB treatment. CONCLUSIONS: Social and health factors together influence non-completion of TB treatment in HIV-infected patients, while health interventions can impr ove treatment completion.