Tuberculosis among HIV-1-infected subjects in a tertiary out-patient service in São Paulo city, Brazil

Casseb, Jorge; Fonseca, Luiz Augusto Marcondes; Medeiros, Lucas A.; Gonsalez, Claudio Roberto; Lagonegro, Eduardo Ronner; Veiga, Ana Paula Rocha; Silva, Daniela C. da; Mendonça, Marcelo; Duarte, Alberto J. S.

doi:10.1590/s0036-46652012000500004

Cited by 5 publications

(7 citation statements)

References 8 publications

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“…The prevalence of TB documented in HIV patients on HAART in this study is comparable with findings in Brazil (6.8%-all forms of TB),[ 28 ] Tanzania (8.5%-pulmonary TB),[ 29 ] and Ethiopia (10.1%-all forms of TB). [ 30 ] The study in Brazil was a retrospective analysis of 599 HIV-positive patients out of whom 59% were on HAART.…”

Section: Discussionsupporting

confidence: 85%

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Factors associated with prevalent tuberculosis among patients receiving highly active antiretroviral therapy in a Nigerian tertiary hospital

Ofondu

Mbata

et al. 2016

Ann Med Health Sci Res

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Background:Tuberculosis (TB) causes significant morbidity/mortality among human immunodeficiency virus-infected individuals in Africa. Reducing TB burden in the era of highly active antiretroviral therapy (HAART) is a public health priority.Aim:We determined the factors associated with prevalent TB among patients receiving HAART.Subjects and Methods:We conducted a cross-sectional study of adult patients who had received HAART for ≥12 weeks in a Nigerian tertiary hospital. Patients whose TB diagnosis predated HAART were excluded from the study. Pre-HAART data were collected from the clinic records, whereas post-HAART data were obtained through medical history, physical examination, and laboratory investigations. Standard TB screening/diagnostic algorithms as applicable in Nigeria were used. Logistic regression analysis was used to determine factors independently associated with prevalent TB.Results:about 65.8% (222/339) were women. The mean age was 41.1 (10.0) years and 23.6% (73/339) had past history of TB. The prevalence of active TB was 7.7% (26/339). Among these patients, 42.3% (11/26) had pulmonary TB, 34.6% (9/26) had disseminated TB, whereas 23.1% (6/26) had only extra-pulmonary disease. Only 45% (9/20) of patients with pulmonary involvement had positive sputum smear. Factors independently associated with prevalent TB were lower social class (adjusted odds ratio [aOR]: 31.7; 95% confidence interval [CI]: 1.1–1417.3), HAART non-adherence (aOR125.5; 95% CI: 9.6–1636.3), baseline CD4 <200cells/μl (aOR31.0; 95%CI: 1.6–590.6), previous TB (aOR13.8; 95% CI: 2.0–94.1), and current hemoglobin <10 g/dl (aOR10.3; 95% CI: 1.1–99.2).Conclusion:Factors associated with prevalent TB were a lower social class, HAART non-adherence, severe immunosuppression before HAART initiation, previous TB, and anemia post-HAART. TB case finding should be intensified in these high-risk groups.

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Section: Discussionsupporting

confidence: 85%

“…The majority (73%) had pulmonary TB. [ 28 ] The study in Tanzania was cross-sectional and involved 233 patients of whom 74% were women. Children were included in the study though the mean age was 37 (10) years.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with prevalent tuberculosis among patients receiving highly active antiretroviral therapy in a Nigerian tertiary hospital

Ofondu

Mbata

et al. 2016

Ann Med Health Sci Res

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“…In the City of Rio de Janeiro, a study using secondary data demonstrated that between 1996 and 2005, 9% of deaths among individuals living with HIV/AIDS were related to TB (16) . In São Paulo, Casseb et al (17) . reported a 10-year survival rate of 75% following diagnosis for patients who were TB/HIV-positive, compared to a survival rate of 96% for patients from the same cohort who did not have TB (p = 0.03) (17) .…”

Section: Introductionmentioning

confidence: 99%

“…In São Paulo, Casseb et al (17) . reported a 10-year survival rate of 75% following diagnosis for patients who were TB/HIV-positive, compared to a survival rate of 96% for patients from the same cohort who did not have TB (p = 0.03) (17) .…”

Section: Introductionmentioning

confidence: 99%

Temporal distribution of tuberculosis in the State of Amazonas, Brazil

Garrido

Bührer-Sékula

Souza

et al. 2015

Rev. Soc. Bras. Med. Trop.

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63www.scielo.br/rsbmt I www.rsbmt.org.br Revista da Sociedade Brasileira de Medicina Tropical 48(Suppl I):63-69, 2015http://dx.doi. org/10.1590/0037-8682-0055-2014 Review Article ABSTRACT Tuberculosis (TB) is one of the infectious diseases that contributes most to the morbidity and mortality of millions of people worldwide. Brazil is one of 22 countries that accounts for 80% of the tuberculosis global burden. The highest incidence rates in Brazil occur in the States of Amazonas and Rio de Janeiro. The aim of this study was to describe the temporal distribution of TB in the State of Amazonas. Between 2001 and 2011, 28,198 cases of tuberculosis were reported in Amazonas, distributed among 62 municipalities, with the capital Manaus reporting the highest (68.7%) concentration of cases. Tuberculosis was more prevalent among males (59.3%) aged 15 to 34 years old (45.5%), whose race/color was predominantly pardo (64.7%) and who had pulmonary TB (84.3%). During this period, 81 cases of multidrug-resistant TB were registered, of which the highest concentration was reported from 2008 onward (p = 0.002). The municipalities with the largest numbers of indigenous individuals affected were São Gabriel da Cachoeira (93%), Itamarati (78.1%), and Santa Isabel do Rio Negro (70.1%). The future outlook for this region includes strengthening the TB control at the primary care level, by expanding diagnostic capabilities, access to treatment, research projects developed in collaboration with the Dr. Heitor Vieira Dourado Tropical Medicine Foundation [Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD)] and fi nancing institutions, such as the project for the expansion of the Clinical Research Center and the creation of a hospital ward for individuals with transmissible respiratory diseases, including TB.

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“…HIV is the most potent risk factor for TB and TB is the leading cause of morbidity and mortality in HIV/AIDS patients [5, 6]. Tuberculosis enhances progression of HIV infection and HIV increases the risk of infection as well as reactivation of latent tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

The effect of incident tuberculosis on immunological response of HIV patients on highly active anti-retroviral therapy at the university of Gondar hospital, northwest Ethiopia: a retrospective follow-up study

et al. 2014

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BackgroundHuman immunodeficiency virus (HIV) infection is usually complicated by high rates of tuberculosis (TB) co-infection. Impaired immune response has been reported during HIV/TB co-infection and may have significant effect on anti-retroviral therapy (ART). TB/HIV co - infection is a major public health problem in Ethiopia. Therefore, the aim of the study was to assess the effect of TB incidence on immunological response of HIV patients during ART.MethodsA retrospective follow-up study was conducted among adult HIV patients who started ART at the University of Gondar Hospital. Changes in CD4+ T - lymphocyte count and incident TB episodes occurring during 42 months of follow up on ART were assessed. Life table was used to estimate the cumulative immunologic failure. Kaplan-Meier curve was used to compare survival curves between the different categories. Cox-proportional hazard model was employed to examine predictors of immunological failure.ResultsAmong 400 HIV patients, 89(22.2%) were found to have immunological failure with a rate of 8.5 per 100 person-years (PY) of follow-up. Incident TB developed in 26(6.5%) of patients, with an incidence rate of 2.2 cases per 100 PY. The immunological failure rate was high (20.1/100PY) at the first year of treatment. At multivariate analysis, Cox regression analysis showed that baseline CD4+ T - cell count <100 cells/mm3 (adjusted hazard ratio (AHR) 1.8; 95%CI: 1.10 - 2.92, p = 0.023) and being male sex (AHR 1.6; 95%CI: 1.01 - 2.68, p = 0.046) were found to be significant predictors of immunological failure. There was borderline significant association with incident TB (AHR 2.2; 95%CI: 0.94 - 5.09, p = 0.06). The risk of immunological failure was significantly higher (38.5%) among those with incident TB compared with TB - free (21.1%) (Log rank p = 0.036).ConclusionsHigh incidence of immunological failure occurred within the first year of initiating ART. The proportions of patients with impaired immune restoration were higher among patients with incident TB. Lower baseline CD4+ T - cells count of <100 cells/mm3 and being male sex were significant predictors of immunological failure. The result highlighted the beneficial effects of earlier initiation of ART on CD4+ T - cell count recovery.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-468) contains supplementary material, which is available to authorized users.

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Tuberculosis among HIV-1-infected subjects in a tertiary out-patient service in São Paulo city, Brazil

Cited by 5 publications

References 8 publications

Factors associated with prevalent tuberculosis among patients receiving highly active antiretroviral therapy in a Nigerian tertiary hospital

Factors associated with prevalent tuberculosis among patients receiving highly active antiretroviral therapy in a Nigerian tertiary hospital

Temporal distribution of tuberculosis in the State of Amazonas, Brazil

The effect of incident tuberculosis on immunological response of HIV patients on highly active anti-retroviral therapy at the university of Gondar hospital, northwest Ethiopia: a retrospective follow-up study

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