C106-10 Profile of Drug-resistant Tuberculosis Patients With Human Immunodeficiency Virus (HIV) in Indonesia: Analysis of the National Tuberculosis Registry Data

Abstract Rationale Tuberculosis (TB) remains a major global health challenge, affecting an estimated 10.8 million people worldwide. Indonesia ranks second globally in TB burden, with approximately one million cases annually. The prevalence of drug-resistant (DR) TB is also among the highest, with about 7.4% of cases classified as rifampicin-resistant (RR) or multidrug-resistant (MDR) TB. Indonesia is likewise a high-burden country for TB-HIV coinfection. National data showed that 4% of all TB patients are HIV-positive. Since there is a lack of data regarding the clinical profile of DR-TB with HIV in Indonesia, in this study we would like to describe the clinical characteristics and treatment outcomes of DR-TB patients coinfected with HIV in Indonesia. Methods We conducted a retrospective analysis using data from the 2022 Indonesia National Tuberculosis Registry (SITB). Patients with confirmed DR-TB were included. Extracted variables comprised characteristics, drug-resistance pattern (RR, MDR, pre-XDR, XDR), anatomic site of disease, HIV status, sputum and culture conversion at months 1, 2, and 6, and treatment outcome. Ethical approval was obtained from the Persahabatan Hospital Ethics Committee (No. 0199/KEPK-RSUPP/08/2024). Results In 2022, 8,497 DR-TB cases were reported, of which 4,590 (54%) lacked recorded HIV status and 2,420 (28.5%) had no documented treatment outcome. Among 1,487 (17.5%) patients with complete data, 121 (8.1%) were HIV-positive. Most HIV-positive patients were male (n = 93, 76.8%), and all had pulmonary involvement. The highest proportion was among those aged 25-49 years (n = 95, 78.5%). The most common treatment history was new cases (n = 44, 36.4%) followed by relapse (n = 33, 27.3%). Rifampicin resistance was the predominant pattern (n = 94, 77.7%). Sputum conversion rates at months 1, 2, and 6 were 40.5% (49 patients), 42.1% (51), and 35.5% (43), respectively, while culture conversion rates were 38.0% (46), 39.7% (48), and 30.6% (37). Among HIV-positive DR-TB patients, treatment success and completion rates were 23.1% (28) and 9.9% (12), respectively, with treatment failure 9.9% (12), mortality 38.8% (47), and loss to follow-up 18.2% (22). Conclusions Drug-resistant TB patients with HIV experience poor treatment outcomes, characterized by low conversion and success rates and high mortality. Routine HIV testing for all DR-TB patients should be mandatory to ensure accurate classification and comprehensive management. Strengthening integrated TB-HIV services, expanding HIV screening, and improving SITB data completeness are essential to enhance outcomes and national surveillance reliability. This abstract is funded by: self-funded