It is known that patients with HIV are at a higher risk of Mycobacterium tuberculosis infection. But the clinical and epidemiological significance of HIV-associated tuberculosis bloodstream infection (BSI) is not well understood. The objective of this study is to evaluate the infection prevalence and mortality risk in seriously ill HIV patients.
This systematic review and meta-analysis included a total of 23 datasets that performed routine mycobacterial blood culture in a prospectively defined patient population. The included participants had to pass the following inclusion criteria: 13 years or older, available CD4 cell count, HIV positivity, a valid mycobacterial blood culture, and suspected tuberculosis. The primary outcomes of the study were tuberculosis prevalence and mortality.
The predicted probability of tuberculosis BSI in patients with HIV-associated tuberculosis was 45%. The presence of tuberculosis BSI in patients with HIV-associated tuberculosis increased the risk of mortality in the first 30 days, but not after 30 days. The findings also suggested that the risk of mortality increased in patients with tuberculosis BSI, who had a delay in tuberculosis treatment of more than 4 days (odds ratio 3.15).
The research concluded that tuberculosis BSI in adults with HIV-associated tuberculosis was associated with an increased risk of mortality within 30 days, especially when the treatment was delayed by 4 days or longer.