Cumulative incidence and factors associated with unfavorable tuberculosis treatment outcomes among people living with HIV in Liangshan, China: a competing-risk analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Cure or treatment completion precludes a later unfavorable tuberculosis (TB) treatment outcome within the same treatment episode and should be treated as a competing event. We estimated the cumulative incidence and exploratory associated factors for unfavorable outcomes among people with HIV-associated TB in Liangshan, China. Methods Aalen–Johansen cumulative incidence functions and Fine–Gray subdistribution hazard models were used. The 14-parameter full model was treated as exploratory; a prespecified three-parameter Fine–Gray sensitivity model, a cause-specific hazards model, and a proportionality assessment were included. Pointwise 95% confidence intervals for the cumulative incidence functions were obtained using 2,000 individual-level bootstrap resamples. Results Among 340 closed treatment episodes, 27 unfavorable outcomes, 303 cure/completion events, and 10 administrative censorings were observed. The unfavorable cumulative incidence was 4.41% (95% CI 2.35–6.77) at 3 months, 6.47% (3.82–9. 12) at 6 months, 7.65% (5.00–10.60) at 9 months, and 7.96% (5.30–10.91) at 12 months. Twenty-two of 27 unfavorable outcomes (81.5%) were records coded as non-TB death; the source field contained no separate TB-related-death category. In the full exploratory model, age was associated with the outcome (adjusted sHR 1.54 per 10 years, 95% CI 1.02–2.32; p = 0.039). In the parsimonious model, age (sHR 1.70, 95% CI 1.18–2.43; p = 0.004) and tracing versus all other sources (sHR 4.73, 95% CI 1.89–11.86; p = 0.001) showed elevated estimates, while inference remained exploratory. Conclusion The 12-month unfavorable cumulative incidence was 7.96% (95% CI 5.30–10.91), with only 33 individuals at risk at that landmark. The mortality-dominated composite and sparse categories limit interpretation; the findings describe exploratory associations rather than a validated prediction model.
Source: Frontiers in Public Health
Authors: Ni Yang, Ting Li, Yunkui Li, Lan Xia
Institution: Sichuan Center for Disease Control and Prevention
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223103473