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
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.
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