Objetivos. Analizar e identificar factores asociados a la recurrencia de la tuberculosis (TB) en pacientes infectados por el virus de la inmunodeficiencia humana (VIH). Pacientes y métodos. Se seleccionaron pacientes infectados por VIH diagnosticados de TB entre 1995-2000 y que completaron el tratamiento correctamente. Se compararon aquellos pacientes que presentaron una recurrencia de enfermedad tuberculosa con los que no lo hicieron. Se realizó análisis multivariante por regresión logística para identificar factores asociados a un nuevo episodio de TB. Resultados. De un total de 223 pacientes infectados por VIH diagnosticados de TB, 159 (71,3%) completaron adecuadamente el tratamiento y fueron considerados curados. El resto fueron excluidos por fallecer antes de completar el tratamiento (5,8%), perdidos en el seguimiento (11,7%), abandono terapéutico (9,4%) y fracaso terapéutico (1,8%). De los 159 pacientes evaluables, 14 (8,8%) presentaron posterior recurrencia. Los pacientes con TB recurrente presentaron un mayor grado de inmunodepresión, más eventos previos diagnósticos de sida y mayor frecuencia de TB extrapulmonar en el episodio inicial. Tras el análisis multivariante, un recuento de linfocitos CD4 inferior a 100/mm3 en el primer episodio de TB se asoció con enfermedad tuberculosa recurrente (odds ratio [OR]: 4,6; intervalo de confianza [IC] 95%:1,3-18,2). En los episodios recurrentes la mortalidad fue alta (35,7%). Conclusiones. La recurrencia de TB en pacientes coinfectados por VIH ocurre en individuos con inmunodepresión profunda y se asocia a una alta mortalidad.

Objectives. Analysis and identification of factors associated with the tuberculosis (TB) recurrence in HIV-infected patients. Patients and methods. The HIV-infected patients diagnosed with TB between 1995-2000 and with correct completion of the treatment were selected. There were compared those patients who presented a tuberculous disease recurrence with those which did not presented it. Multivariate analysis was carried out by logistic regression in order to identify factors associated with a new episode of TB. Results. In the total sample of 223 diagnosed HIV-infected patients with TB, 159 (71.3%) patients completed adequately the treatment and were considered cured. The rest were excluded because of: death before completing the treatment (5.8%), lost in the follow-up (11.7%), therapeutic abandonment (9.4%), and therapeutic failure (1.8%). In the 159 patient final sample, 14 (8.8%) patients presented later recurrence. The patients with recurrent TB presented a greater degree of immunosuppression, more previous complications indicative of AIDS, and greater frequency of extrapulmonary TB in the initial episode. After the multivariate analysis, a count of lymphocytes CD4 lower than 100/mm3 in the first episode of TB was associated with recurrent tuberculous disease (odds ratio [OR]: 4,6; 95% confidence index [CI]: 1,3-18,2). Mortality was high (35.7%) in the patients with recurrent episodes. Conclusions. The recurrence of TB in patients coinfected by HIV occurs in individuals with profound immunossuppression and is associated to high mortality.