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Volume 32, Number 3—March 2026

Dispatch

Tuberculosis after TB Preventive Therapy in Persons Living with HIV Recently Initiating Antiretroviral Therapy, Mozambique

Lindsay TemplinComments to Author , Yagna Varajidas, Durval Respeito, Pereira Zindoga, Debora Weiss, Alexandre Nguimfack, Eudoxia Filipe, Arlete Mahumane, Maria Inês Tomo de Deus, José Mizela, Sonia Chilundo, Bruno Simoes, Aleny Couto, Ishani Pathmanathan, Emilio Dirlikov, and Benedita José
Author affiliation: US Centers for Disease Control and Prevention, Maputo, Mozambique (L. Templin, Y. Varajidas, D. Respeito, A. Nguimfack, A. Mahumane, M. Tomo de Deus, J. Mizela, S. Chilundo, I. Pathmanathan, E. Dirlikov); US Agency for International Development, Maputo (P. Zindoga); Ministry of Health Mozambique, Maputo (E. Filipe, B. Simoes, A. Couto, B. José); US Centers for Disease Control and Prevention, Atlanta, Georgia, USA (D. Weiss)

Main Article

Table 2

Incidence of TB among persons living with HIV newly initiated on ART after 2 years of follow-up, Mozambique, 2021–2024*

Characteristic No. TB positive Person-years Incidence (95% CI) Univariate analysis
Multivariate analysis
IRR (95% CI) p value IRR (95% CI) p value
TPT completion status
Complete 1,550 492,835 3.1 (3.0–3.3) Referent Referent
Incomplete 1,346 122,675 11.0 (10.4–11.6) 3.5 (3.2–3.8) <0.001 3.83 (3.5–4.2) <0.001
Not started
231
10,705
21.6 (18.9–24.5)
6.9 (5.7–8.3)
<0.001

5.25 (4.4–6.3)
<0.001
Sex
F 1,553 393,961 3.9 (3.7–4.1) Referent Referent
M
1,574
232,254
6.8 (6.4–7.1)
1.7 (1.6–1.9)
<0.001

1.56 (1.4–1.7)
<0.001
Viral load result†
Suppressed 2,603 579,825 4.5 (4.3–4.7) Referent Referent
Not suppressed
524
46,390
11.3 (10.3–12.3)
2.5 (2.3–2.8)
<0.001

2.28 (2.0–2.5)
<0.001
Age group
15–49 2,352 541,281 4.3 (4.2–4.5) Referent Referent
>50 477 52,035 9.2 (8.4–10.0) 2.1 (1.9–2.4) <0.001 1.55 (1.4–1.8) <0.001
<15
298
32,899
9.1 (8.1–10.1)
2.1 (1.8–2.4)
<0.001

1.76 (1.6–2.0)
<0.001
TPT regimen‡
Isoniazid 2,672 583,015 4.6 (4.4–4.8) Referent
3HP 224 32,495 6.9 (6.0–7.9) 1.5 (1.2–1.8) <0.001
No TPT
231
10,705
21.6 (18.9–24.5)
4.7 (3.9–5.6)
<0.001



Health facility setting
Rural 1,749 392,126 4.5 (4.3–4.7) Referent Referent
Urban
1,378
234,089
5.9 (5.6–6.2)
1.3 (1.1–1.5)
<0.001

1.21 (1.1–1.4)
<0.001
Region§
Northern 796 185,636 4.3 (4.0–4.6) Referent Referent
Central 1,295 289,951 4.5 (4.2–4.7) 1.0 (0.9–1.3) 0.67 0.84 (0.7–1.0) 0.02
Southern
1,036
150,628
6.9 (6.5–7.3)
1.6 (1.4–1.9)
<0.001

1.51 (1.3–1.8)
<0.001
Latest CD4 result
>200 cells/mm3 550 72,187 7.6 (7.0–8.3) Referent Referent
<200 cells/mm3 326 16,597 19.6 (17.6–21.9) 2.6 (2.2–3.0) <0.001 2.11 (1.8–2.5) <0.001
Not tested
2,251
537,431
4.2 (4.0–4.4)
0.5 (0.5–0.6)
<0.001

0.58 (0.5-0.7)
<0.001
WHO staging status at ART start
Stage I 2,117 509,232 4.2 (4.0–4.3) Referent Referent
Stage II 551 77,186 7.1 (6.6–7.8) 1.7 (1.5–1.9) <0.001 1.61 (1.5–1.8) <0.001
Stage III 345 24,948 13.8 (12.4–15.4) 3.3 (3.0–3.8) <0.001 2.62 (2.3–3.0) <0.001
Stage IV 51 4,201 12.1 (9.0–16.0) 2.9 (2.3–3.8) <0.001 1.89 (1.5–2.4) <0.001
Not recorded
63
10,649
5.9 (4.5–7.6)
1.4 (1.1–1.9)
0.01

1.29 (1.0–1.7)
0.06
Started TPT within 30 d of ART initiation‡
TPT at ART start 2,569 572,983 4.5 (4.3–4.7) Referent
Delayed TPT start 327 42,527 7.7 (6.9–8.9) 1.7 (1.5–1.9) <0.001
Not started 231 10,705 21.6 (18.9–24.5) 4.8 (4.0–5.8) <0.001

*Incidence is cases/1,000 person-years. IRR, incidence rate ratio, TPT, TB prevention therapy, 3HP, 3-month course of 12 (1/wk) doses of isoniazid and rifapentine. †Suppressed: <1,000 copies/mL; unsuppressed: >1,000 copies/mL. ‡Variable not included in multivariate analysis. §Mozambique’s 11 provinces are categorized into 3 regions: Central (Sofala, Manica, Tete, Zambezia), Northern (Nampula, Niassa, Cabo Delgado), and Southern (Maputo City, Maputo, Gaza, Inhambane).

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Page created: February 13, 2026
Page updated: February 26, 2026
Page reviewed: February 26, 2026
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