Prevalence and factors associated with co-infection among patients living with HIV at the Mbandaka General Referral Hospital, Democratic Republic of the Congo: a retrospective study 2023–2024

Abstract

Introduction: In the Democratic Republic of the Congo (DRC), co-infection among people living with HIV (PLHIV) remains a major challenge. This study aimed to determine the prevalence and factors associated with co-infection (opportunistic infections or advanced WHO stages 3/4) within the cohort at the Mbandaka General Referral Hospital (HGR).

Methods: A retrospective cross-sectional study was conducted on 52 records of PLHIV followed between January 2023 and December 2024. Sociodemographic, clinical, biological and therapeutic data were analysed. Binary logistic regression identified the independent factors associated with co-infection.

Results: The prevalence of co-infection was 65.4% (95% CI: 51.4%–77.8%). Tuberculosis (64.7% of those with co-infections) and candidiasis (52.9%) were the most common opportunistic infections. The mean age was 38.4 ± 14.2 years, with a higher proportion of women (57.7% female). In multivariate analysis, delay in seeking consultation (≥ 3 months) (ORa = 3.60; 95% CI: 1.02–12.71; p = 0.046) and a CD4 count < 350 cells/mm³ (ORa = 4.26; 95% CI: 1.02–17.80; p = 0.047) were independently associated with co-infection. Malnutrition (BMI < 18.5) was close to reaching statistical significance (p = 0.062). Mortality was 13.5%, and 23.1% of patients were lost to follow-up.

Conclusion: Co-infection is highly prevalent in Mbandaka and is diagnosed late. Early screening, reducing delays in initiating ARVs and strengthening prophylaxis (isoniazid) are nursing and clinical priorities.

Keywords: HIV, co-infection, tuberculosis, DRC, Mbandaka, associated factors, late diagnosis.

Received Date: February 22, 2026

Accepted Date: March 14, 2026

Published Date: April 02, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/671