Frequency and risk factors of venous thromboembolic complications in patients with active pulmonary tuberculosis and HIV/TB co-infection (tuberculosis and thrombosis)

Abstract

Introduction/Objective Venous thromboembolism complications (VTEC) include: deep vein thrombosis, superficial vein thrombosis and pulmonary embolism. The aim was to assess the prevalence of VTEC in patients with active pulmonary tuberculosis and to reveal the main factors influencing the development of VTEC in this cohort of patients.

Methods A retrospective study of electronic health records of patients with active pulmonary tuberculosis was carried out. We included all patients with confirmed active pulmonary tuberculosis and VTEC during the period from January 01, 2020 to December 31, 2022.

Results An overall 214 cases of VTEC were identified. The most significant risk factors for the development of thrombotic complications in tuberculosis patients were human immunodeficiency viruses (HIV) / tuberculosis co-infection (relative risk 3.8; 95% CI: 2.7–4.5) and the duration of the disease (according to the criterion of formation of fibrosis foci and/or cavities) (relative risk 9.1; 95% CI: 4.7–17.6). The overall prevalence of VTEC in the tuberculosis hospital exceeded the literature data for non-tuberculosis clinics by 3.3 times.

Conclusion Tuberculosis is a major reversible risk factor for the venous thromboembolic events, probably due to impaired coagulation mechanisms, venous stasis and endothelial dysfunction. HIV infection in this context is the second major reversible factor in the development of VTEC.

Keywords: venous thrombosis; tuberculosis; thromboembolism; HIV; hypercoagulation