Tuberculosis (TB) treatment outcomes in relation to smoking history of HIV patients in Kinshasa, the Democratic Republic of Congo
| All patients (n=533) | ART during TB treatment# (n=367) | No ART during TB treatment# (n=166) | |
| All ever-smokers ¶ (n=135) | |||
| Crude HR for LTFU | 2.43 (1.43–4.13) | 2.05 (0.86–4.88) | 2.17 (1.11–4.26) |
| Adjusted HR for LTFU | 2.40 (1.13–5.11) | 2.77 (0.95–8.08) | 1.67 (0.70–3.97) |
| Crude HR for death | 2.00 (1.10–3.63) | 2.37 (0.92–6.10) | 1.49 (0.69–3.22) |
| Adjusted HR for death | 0.87 (0.38–1.98) | 1.50 (0.48–4.67) | 1.08 (0.19–6.33) |
| Crude HR for adverse outcome+ | 2.15 (1.45–3.20) | 2.14 (1.13–4.06) | 1.73 (1.05–2.87) |
| Adjusted HR for adverse outcome+ | 1.57 (1.00–2.47) | 2.21 (1.16–4.22) | 1.15 (0.46–2.88) |
| Duration of smoking | |||
| Smoked >10 years¶ (n=79) | |||
| Crude HR for LTFU | 2.89 (1.58–5.26) | 2.46 (0.89–6.84) | 2.29 (1.08–4.84) |
| Adjusted HR for LTFU | 2.71 (1.01–7.28) | 5.11 (0.96–27.06) | 1.37 (0.52–3.60) |
| Crude HR for death | 2.93 (1.55–5.54) | 4.55 (1.76–11.73) | 1.62 (0.68–3.88) |
| Adjusted HR for death | 1.64 (0.63–4.26) | 3.81 (0.99–14.58) | 0.80 (0.11–5.53) |
| Crude HR for adverse outcome+ | 2.79 (1.80–4.31) | 3.28 (1.65–6.52) | 1.84 (1.05–3.25) |
| Adjusted HR for adverse outcome+ | 2.39 (1.36–4.22) | 4.62 (2.09–10.21) | 1.04 (0.39–2.73) |
| Smoked <10 years¶ (n=56) | |||
| Crude HR for LTFU | 1.84 (0.85–4.00) | 1.58 (0.46–5.51) | 1.98 (0.74–5.34) |
| Adjusted HR for LTFU | 3.04 (1.23–7.53) | 1.74 (0.44–6.95) | § |
| Crude HR for death | 0.72 (0.25–2.65) | 0.04 (0.00–143.00) | 1.24 (0.37–4.22) |
| Adjusted HR for death | 0.41 (0.09–1.75) | § | 0.38 (0.04–3.69) |
| Crude HR for adverse outcome+ | 1.33 (0.70–2.52) | 0.89 (0.27–2.96) | 1.52 (0.71–3.28) |
| Adjusted HR for adverse outcome+ | 1.28 (0.67–2.44) | 0.87 (0.25–3.00) | 1.45 (0.66–3.15) |
| Duration since exposure | |||
| Current and recent smokers¶ (n=42) | |||
| Crude HR for LTFU | 2.70 (1.24–5.85) | 2.07 (0.47–9.12) | 1.96 (0.78–4.94) |
| Adjusted HR for LTFU | 3.09 (1.01–9.39) | 3.70 (0.47–29.21) | 1.51 (0.30–7.62) |
| Crude HR for death | 3.15 (1.44–6.89) | 4.11 (1.15–14.73) | 1.81 (0.67–4.87) |
| Adjusted HR for death | 2.03 (0.70–5.93) | 3.93 (0.63–24.33) | 1.27 (0.18–9.28) |
| Crude HR for adverse outcome+ | 2.77 (1.60–4.81) | 2.87 (1.10–7.50) | 1.77 (0.90–3.49) |
| Adjusted HR for adverse outcome+ | 2.71 (1.42–5.16) | 3.75 (1.00–14.10) | 1.48 (0.49–4.52) |
| Former smokers¶ (n=93) | |||
| Crude HR for LTFU | 2.32 (1.27–4.22) | 2.03 (0.78–5.29) | 2.34 (1.08–5.06) |
| Adjusted HR for LTFU | 2.62 (1.19–5.75) | 2.09 (0.70–6.18) | 1.77 (0.47–6.66) |
| Crude HR for death | 1.50 (0.71–3.18) | 1.79 (0.57–5.62) | 1.26 (0.47–3.38) |
| Adjusted HR for death | 0.53 (0.19–1.48) | 1.22 (0.33–4.48) | 0.16 (0.02–1.31) |
| Crude HR for adverse outcome+ | 1.88 (1.18–2.99) | 1.89 (0.91–3.94) | 1.70 (0.93–3.10) |
| Adjusted HR for adverse outcome+ | 1.25 (0.74–2.12) | 1.92 (0.92–3.99) | 0.92 (0.34–2.50) |
Data are presented as estimate (95% CI), unless otherwise stated. Analysis was performed by Cox proportional hazard modelling using a 10% change in estimate approach for the covariates sex, age (quintiles), underweight, functional status (ambulatory versus in bed more than usual), CD4 cell count category (<50, 50–99, 100–350, >350 cells·mm−3), ART initiation during TB treatment, extrapulmonary TB, completion of secondary education, employment, food insecurity (hungry in the past week), multiple sexual partners (excluded for the mortality analysis), sexual activity before age 13 years of age (excluded for the mortality analysis), and heavy alcohol consumption (World Health Organisation 2014 definition [6]). ART: antiretroviral treatment; HR: hazard ratio; LTFU: lost to follow-up. #: ART initiated within 6 months following start of TB treatment; ¶: compared to patients who never smoked; +: mortality and loss to follow-up during TB treatment combined; §: number of patients too low to perform this analysis.