HIV Co-Infection Increases Mortality and Impairs Functional Independence and Physical Performance in Hospitalized Tuberculosis Patients

Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) infection have been found to impact physical function significantly. However, data regarding the effect of TB/HIV co-infection on functional status remain limited. This study aimed to assess the impact of HIV co-infection on the functional independence and physical performance of TB patients during hospitalization, and associated mortality.

This cross-sectional study included hospitalized TB patients from the Brazilian infectious diseases reference center. Their sociodemographic and clinical characteristics were recorded. Functional independence was assessed using the Functional Independence Measure (FIM), and physical performance was evaluated with the Short Physical Performance Battery (SPPB).

A total of 49 patients were included: 22 with TB/HIV co-infection and 27 with TB-only. The TB-only group showed significant increases in total FIM scores (p=0.027) and SPPB (p = 0.001) at discharge compared to admission, which was not observed in the TB/HIV co-infected group. Mortality occurred only in the TB/HIV co-infected group (p=0.01).

This study demonstrated that HIV co-infection impaired functional independence and physical performance in TB patients during hospitalization. This impairment was associated with poorer clinical outcomes, including elevated mortality, which aligns with previously documented HIV-related functional deficits. Our findings, which reveal higher mortality among co-infected individuals, are consistent with the widely recognized role of functional limitations in predicting poorer patient outcomes.

The present study highlights the detrimental effect of HIV co-infection on both functional outcomes and survival in hospitalized TB patients. This underscores the urgent need for integrated care strategies to enhance functional outcomes and reduce mortality in this population.