Skip to main content

Free Content Impact of tuberculosis on the course of HIV-infected patients with a high initial CD4 lymphocyte count

Download Article:
 Download
(PDF 239 kb)
 

Abstract:

OBJECTIVE: To assess the influence of tuberculosis (TB) on the progression of human immunodeficiency virus (HIV) infection in patients without immunological impairment.

MATERIAL AND METHODS: In an observational study of retrospective cohorts, the evolution of 28 HIV-infected patients with TB and a CD4 lymphocyte count >500 × 106 cells/l was compared with 56 HIV-infected patients without TB. Each case was paired with two controls by CD4 lymphocyte count (±50 × 106/l) and date of starting follow-up (±6 months). The progression of HIV infection was evaluated as: 1) immunological progression: time to CD4 lymphocyte count <200 × 106/l; 2) clinical progression: time to development of acquired immune-deficiency syndrome (AIDS), excluding TB; 3) survival; and 4) global disease progression: time to the first defined event in 1, 2 and/or 3. The times to these events were estimated using Kaplan Meier curves.

RESULTS: There were no significant differences between the cohorts for age, sex and risk group. Faster immunological impairment (RR 2.94; 95%CI 1.46–8.6; P < 0.01), greater progression to AIDS (RR 4.01; 95%CI 1.66–9.69; P < 0.01), lower survival (RR 3.89; 95%CI 1.53–9.87; P < 0.05) and higher global disease progression (RR 2.82; 95%CI 1.57–5.09; P < 0.01) were found in the cohort of TB patients. These associations were still significant after adjustment for CD4 lymphocyte counts.

CONCLUSION: The diagnosis of TB in HIV-infected patients with a high initial CD4 lymphocyte count (>500 × 10 6/L) was related to greater progression to AIDS and shorter survival.

Keywords: CD4 T-lymphocytes; HIV infection; prognosis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Departamento de Neumología, Hospital Ramón y Cajal, Madrid, Spain 2: Unidad VIH, Hospital 12 Octubre, Madrid, Spain 3: Unidad VIH, Hospital La Paz, Madrid, Spain

Publication date: April 1, 2004

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
iuatld/ijtld/2004/00000008/00000004/art00011
dcterms_title,dcterms_description,pub_keyword
6
5
20
40
5

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more