Survival of HIV-infected patients after starting tuberculosis treatment: a prospective cohort study
Abstract:OBJECTIVES: To estimate the probability of survival and to evaluate risk factors for death in a cohort of persons living with human immunodeficiency virus (PLHIV) who had started tuberculosis (TB) treatment.
METHODS: A prospective cohort study was conducted between June 2007 and December 2009 with HIV-infected patients who had started anti-tuberculosis treatment in the State of Pernambuco, Brazil. Survival data were analysed using the Kaplan-Meier estimator, the log-rank test and the Cox model. Hazard ratios and their respective 95%CIs were estimated.
RESULTS: Of a cohort of 2310 HIV-positive individuals, 333 patients who had commenced treatment for TB were analysed. The mortality rate was 5.25 per 10 000 person-years (95%CI 4.15–6.63). The probability of survival at 30 months was 74%. Risk factors for death in the study population were being female, age ≥30 years, having anaemia, not using highly active antiretroviral therapy (HAART) during treatment for TB and disseminated TB. Protective factors for death were a CD4 lymphocyte count >200 cells/mm3 and treatment for TB having started in an out-patient clinic.
CONCLUSIONS: The use of HAART can prevent deaths among HIV-TB patients, corroborating the efficacy of starting HAART early in individuals with TB.
Document Type: Research Article
Affiliations: 1: Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil 2: Centro de Pesquisas Aggeu Magalhães/Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil 3: Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 4: Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil 5: London School of Hygiene & Tropical Medicine, London, UK
Publication date: May 1, 2012
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