Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil

Siqueira-Filha, Noemia Teixeira de; Albuquerque, Maria de Fátima Militão de; Rodrigues, Laura C.; Legood, Rosa; Santos, Andréia Costa

doi:10.1136/sextrans-2017-053277

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…It was found that the population characteristics of TB/HIV infection were different in different demographic variables. In terms of age, patients aged 20-40 had the highest HIV infection rate, followed by patients aged over 40, and patients aged younger than 20 had the lowest HIV infection rate, which was similar to the study results of Teixeira et al (2018) (24). The reason may be that people over 40 were sexually active and had higher rates of risky sex.…”

Section: Gene Mutation Characteristics Of Multidrugresistant Mtbsupporting

confidence: 89%

Influence of Dexmedetomidine on Cognitive Function and Inflammatory Factors in Rats and Analysis of Its Molecular Mechanism after Cardiac Surgery under Cardiopulmonary Bypass

Yang

Zheng

Zhang

et al. 2022

Cell Mol Biol (Noisy-le-grand)

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The study aimed to explore the influence of Dexmedetomidine (Dex) on cognitive function and inflammatory factors in rats after cardiac surgery under cardiopulmonary bypass (CPB). For this purpose, 30 healthy male SD rats were reared in a quiet and clean environment with alternating light for 12 hours. They were rolled randomly into 3 groups, each with 10 rats, namely the control (Ctrl) group, the experimental group, and the Dex group. The rats in the Ctrl were not treated, and the rats in the experimental group were intraperitoneally injected with 50μg/kg saline. After that, cardiac surgery was performed under CPB. Rats in the Dex group were injected with 50 μg/kg Dex intraperitoneally and underwent cardiac surgery under CPB. The Morris water maze (MWM) experiment was performed to test the learning and memory abilities and spatial positioning abilities of SD rats. Enzyme-linked immunosorbent assay (ELISA method) was adopted to detect the contents of TNF-α, IL-6, and IL-1β. Fluorescence quantitative PCR was applied to determine the mRNA expression levels of TNF-α, IL-6, and IL-1β in the hippocampus. Results showed that in the MWM experiment, in contrast with the Ctrl, the escape latency of the experimental group and the Dex group after surgery were prolonged (P<0.05), and the times they crossed platforms reduced (P<0.05). In contrast with the experimental group, the escape latency of the Dex group shortened, and the times they crossed platforms increased. ELISA suggested that in contrast with the experimental group, the concentrations of TNF-α, IL-6, and IL-1β in the Ctrl decreased (P<0.05), and those in the Dex group decreased slightly. In the fluorescence quantitative PCR experiment, in contrast with the experimental group, the mRNA expression levels of TNF-α, IL-6, and IL-1β in the Ctrl increased, and those in the Dex group decreased slightly. Then Dex can improve the cognitive dysfunction of rats undergoing cardiac surgery under CPB, and its molecular mechanism may be to reduce the inflammation around the heart and hippocampus.

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Section: Gene Mutation Characteristics Of Multidrugresistant Mtbsupporting

confidence: 89%

Influence of Dexmedetomidine on Cognitive Function and Inflammatory Factors in Rats and Analysis of Its Molecular Mechanism after Cardiac Surgery under Cardiopulmonary Bypass

Yang

Zheng

Zhang

et al. 2022

Cell Mol Biol (Noisy-le-grand)

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“…Another limitation was that our dataset did not include socioeconomic status measures such as income, education, and assets, which are important predictors of seeking and sustaining medical treatments, especially in resource-limited countries. For instance, Teixeira de Siqueira-Filha and colleagues concluded that patients with TB/HIV coinfection had a higher economic burden than patients with HIV only and also that death resulting from TB/HIV coinfection can cost almost three times more than a death attributable to AIDS [ 34 ]. Thus, extremely poor patients may decide to purchase food instead of medication.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for TB/HIV Coinfection and Consequences for Patient Outcomes: Evidence from 241 Clinics in the Democratic Republic of Congo

Shah

Ewetola²,

Etheredge

et al. 2021

IJERPH

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(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from 241 HIV/AIDS clinics in Haut-Katanga and Kinshasa, two provinces in the Democratic Republic of Congo. Chi-square and logistic regression analysis were performed. (3) Results: Significantly higher proportions of patients with TB/HIV coinfection were men (4.5%; women, 3.3%), were new patients (3.7%; transferred-in, 1.6%), resided in the Kinshasa province (4.0%; Haut-Katanga, 2.7%), and were in an urban health zone (3.9%) or semi-rural health zone (3.1%; rural, 1.2%). Logistic regression analysis showed that after controlling for demographic and clinical variables, TB/HIV coinfection increased the risk of death (adjusted odds ratio (AOR), 2.26 (95% confidence interval (CI): 1.94–2.64)) and LTFU (AOR, 2.06 (95% CI: 1.82–2.34)). TB/HIV coinfection decreased the odds of viral load suppression (AOR, 0.58 (95% CI: 0.46–0.74)). (4) Conclusions: TB/HIV coinfection raises the risk of negative outcomes such as death, LTFU, and lack of viral load suppression. Our findings can help HIV clinics in Democratic Republic of Congo and other African countries to customize their interventions to improve HIV care and reduce care disparities among patients.

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“…The fixed or random-effect model was applied based on the heterogeneity test. If I 2 >50% or p<0.10, we selected the random-effects model; otherwise, we applied the fixed-effects model. Meta-regression analysis was used to explore the causes of heterogeneity.…”

Section: Methodsmentioning

confidence: 99%

“…Globally, an estimated 10.0 million people fell ill with tuberculosis in 2018, a number that has been relatively stable in recent years. 1 Coinfection with tuberculosis and AIDS, 2 tuberculosis and diabetes, 3 liver damage caused by antituberculosis drugs 4 and ambient air pollution 5 are all huge obstacles to achieve the 'End Tuberculosis Goal'. According to the WHO, the number of persons with both incident and prevalent tuberculosis remains the highest in the South-East Asian and African regions.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cytokines as a biomarker to distinguish active tuberculosis from latent tuberculosis infection: a diagnostic meta-analysis

Qiu

et al. 2020

BMJ Open

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ObjectivesWith a marginally effective vaccine and no significant breakthroughs in new treatments, a sensitive and specific method to distinguish active tuberculosis from latent tuberculosis infection (LTBI) would allow for early diagnosis and limit the spread of the pathogen. The analysis of multiple cytokine profiles provides the possibility to differentiate the two diseases.DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Library, Clinical Key and EMBASE databases were searched on 31 December 2019.Eligibility criteriaWe included case–control studies, cohort studies and randomised controlled trials considering IFN-γ, TNF-α, IP-10, IL-2, IL-10, IL-12 and VEGF as biomarkers to distinguish active tuberculosis and LTBI.Data extraction and synthesisTwo students independently extracted data and assessed the risk of bias. Diagnostic OR, sensitivity, specificity, positive and negative likelihood ratios and area under the curve (AUC) together with 95% CI were used to estimate the diagnostic value.ResultsOf 1315 records identified, 14 studies were considered eligible. IL-2 had the highest sensitivity (0.84, 95% CI: 0.72 to 0.92), while VEGF had the highest specificity (0.87, 95% CI: 0.73 to 0.94). The highest AUC was observed for VEGF (0.85, 95% CI: 0.81 to 0.88), followed by IFN-γ (0.84, 95% CI: 0.80 to 0.87) and IL-2 (0.84, 95% CI: 0.81 to 0.87).ConclusionCytokines, such as IL-2, IFN-γ and VEGF, can be utilised as promising biomarkers to distinguish active tuberculosis from LTBI.PROSPERO registration numberCRD42020170725.

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Economic burden of HIV and TB/HIV coinfection in a middle-income country: a costing analysis alongside a pragmatic clinical trial in Brazil

Abstract: RBR-22t943, Results.

Cited by 8 publications

References 9 publications

Influence of Dexmedetomidine on Cognitive Function and Inflammatory Factors in Rats and Analysis of Its Molecular Mechanism after Cardiac Surgery under Cardiopulmonary Bypass

Influence of Dexmedetomidine on Cognitive Function and Inflammatory Factors in Rats and Analysis of Its Molecular Mechanism after Cardiac Surgery under Cardiopulmonary Bypass

Risk Factors for TB/HIV Coinfection and Consequences for Patient Outcomes: Evidence from 241 Clinics in the Democratic Republic of Congo

Evaluation of cytokines as a biomarker to distinguish active tuberculosis from latent tuberculosis infection: a diagnostic meta-analysis

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