Survival of HIV-infected patients after starting tuberculosis treatment: a prospective cohort study

• Published in: The international journal of tuberculosis and lung disease Vol. 16; no. 5; pp. 618 - 624
• Main Authors: Maruza, M., Albuquerque, M. F. P. M., Braga, M. C., Barbosa, M. T. S., Byington, R., Coimbra, I., Moura, L. V., Batista, J. D. L., Diniz, G. T. N., Miranda-Filho, D. B., Lacerda, H. R., Rodrigues, L. C., Ximenes, R. A. A.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01.05.2012; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Aged; AIDS; Anemia - epidemiology; Anemia - etiology; Antiretroviral Therapy, Highly Active - methods; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Brazil - epidemiology; CD4 Lymphocyte Count; Cohort Studies; Death; Female; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - mortality; Human bacterial diseases; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Mycobacterium; Pneumology; Proportional Hazards Models; Prospective Studies; Respiratory system : syndromes and miscellaneous diseases; Risk; Risk Factors; Sex Factors; Survival Analysis; Survival Rate; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - mortality; Tuberculosis and atypical mycobacterial infections; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Brazil; Brazil, Pernambuco; Immunopathology; Prognosis; Respiratory disease; Risk; AIDS; Mycobacterial infection; Immune deficiency; Survival; Infection; Prospective; Treatment; Tuberculosis; Viral disease; Cohort study; Starting; Risk factor; Bacteriosis; Death; Pneumology
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.11.0110

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.