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

Maruza, Magda; Albuquerque, M. F. P. M.; Braga, Cynthia; Barbosa, Maria Tereza Serrano; Byington, Rita; Coimbra, Isabella; Moura, Libia Vilela; Batista, Joana; Diniz, George Tadeu Nunes; Miranda-Filho, Demócrito Barros; Lacerda, Heloísa Ramos; Rodrigues, Laura C.; Ximenes, Ricardo A. A.

doi:10.5588/ijtld.11.0110

Cited by 17 publications

(17 citation statements)

References 18 publications

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“…Gender was associated with progression to AIDS; the hazard of AIDS among women was significantly higher than among men, as previously reported by others [1,12,27]. Also the survival rate from AIDS to death was not any more significant as previously stated by others [4,13,22,27]. However, based on the study carried out by Mirzaei et al, the survival rate from AIDS to death was higher for women than in men [12].…”

Section: Discussioncontrasting

confidence: 50%

“…One year and five year survival rates from AIDS to death were 76% and 46%, respectively [12]. A prospective cohort study which was carried out by Maruza et al in 2012 in Brazil showed that the probability of 30 months survival among HIV-infected patients was 70% [22]. Spagnuoloet al performed a retrospective cohort study in Italy in 2012 and showed that 10 year survival of HIV infected subjects with non-AIDS-defining malignancies was 44.7% [23].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of HIV Progression to AIDS and Mortality from AIDS and Non- AIDS Related: A Retrospective Cohort Study in Isfahan, Iran

Momenyan¹,

Yadegarfar²,

Meshkati³

et al. 2017

J AIDS Clin Res

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Predictors of HIV Progression to AIDS and Mortality from AIDS and Non- AIDS Related: A Retrospective Cohort Study in Isfahan, Iran

Momenyan¹,

Yadegarfar²,

Meshkati³

et al. 2017

J AIDS Clin Res

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“…The impact of the Brazilian policy has been the object of nationwide studies, mostly focused on mortality [9], [10], [14], [15], the impact on the health system [1], [5], [16] and HIV resistance surveillance [17], [18], as well as small studies with limited representativeness, evaluating the clinical aspects of HIV infection [8], [11], [19] and the use of cART [20]–[24]. However, to date, there have been no nationwide longitudinal studies providing a broader picture of the Brazilian HIV epidemic and the results of the national HIV policy.…”

Section: Introductionmentioning

confidence: 99%

The HIV-Brazil Cohort Study: Design, Methods and Participant Characteristics

Grangeiro

Escuder²,

Cassanote

et al. 2014

PLoS ONE

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BackgroundThe HIV-Brazil Cohort Study was established to analyze the effectiveness of combination antiretroviral therapy (cART) and the impact of this treatment on morbidity, quality of life (QOL) and mortality. The study design, patients’ profiles and characteristics of cART initiation between 2003 and 2010 were described.Methodology/Principal FindingsSince 2003, the HIV-Brazil Cohort has been following HIV-infected adults receiving cART at 26 public health care facilities, using routine clinical care data and self-reported QOL questionnaires. When not otherwise available, data are obtained from national information systems. The main outcomes of interest are diseases related or unrelated to HIV; suppression of viral replication; adverse events; virological, clinical and immunological failures; changes in the cART; and mortality. For the 5,061 patients who started cART between 2003 and 2010, the median follow-up time was 4.1 years (IQR 2.2–5.9 years) with an 83.4% retention rate. Patient profiles were characterized by a predominance of men (male/female ratio 1.7∶1), with a mean age of 36.9 years (SD 9.9 years); 55.2% had been infected with HIV via heterosexual contact. The majority of patients (53.4%) initiated cART with a CD4+ T-cell count ≤200 cells/mm3. The medications most often used in the various treatment regimens were efavirenz (59.7%) and lopinavir/ritonavir (18.2%). The proportion of individuals achieving viral suppression within the first 12 months of cART use was 77.4% (95% CI 76.1–78.6). Nearly half (45.4%) of the patients presented HIV-related clinical manifestations after starting cART, and the AIDS mortality rate was 13.9 per 1,000 person-years.Conclusions/SignificanceResults from cART use in the daily practice of health services remain relatively unknown in low- and middle-income countries, and studies with the characteristics of the HIV-Brazil Cohort contribute to minimizing these shortcomings, given its scope and patient profile, which is similar to that of the AIDS epidemic in the country.

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“…Early diagnosis of TB, as well as the use of HAART, improves prognosis, as its late onset in patients with a previously confirmed diagnosis of TB increases mortality; which highlights the importance of good immunological control in HIV patients. 6,8 TB in Spain may be more common in immigrants. In our study there were 2 patients from Pakistan and one from Eastern Europe, although the only patient that died was native.…”

Section: Discussionmentioning

confidence: 99%

“…4 Conversely, a reduction in the incidence of S. peumoniae invasive disease (bacteremia) has been observed. 5 Pulmonary tuberculosis (TBC) has always been a worldwide health problem with a great impact in the pre-HAART era, in HIV/AIDS population [6][7][8][9] even in the developed world. Nowadays, pulmonary tuberculosis develops in HIV patients with relatively good immunological control and its incidence has become close to that of the immunocompetent population of the same geographical area.…”

Section: Introductionmentioning

confidence: 99%

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients

Perelló

Escoda

Camón

et al. 2015

Enfermedades Infecciosas y Microbiología Clínica

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a b s t r a c tAim: To describe the, incidence, the changes in the etiology and the prognosis of lower respiratory tract infection (LRTI) in HIV infected patients, presenting by the first time to the Emergency Department (ED), during years 2000-2010. Study design: Prospective collection of data. Metbods: Data were collected on the first visit of HIV-infected patients at our ED due to a LRTI, (defined according to the criteria of the European Respiratory Society), between 1/1/2000 and 31/12/2010. A series of epidemiological and laboratory variables as well as the need for admission to the intensive care unit (ICU). LRTI etiology were also collected. The influence ofthe mentioned variables on 30-day mortality were analyzed. Results: One hundred thirty one patients were included. LRTI represented 27% of visits to the ED by HIV-infected patients. Mean age was 39±9 years. 72% of patients were males. 18% required admission to the ICU. The most frequent LRTI was pneumonia by P. jiroveci in 35 cases, bacterial penumonia in 27 and pulmonary tuberculosis in 20. LRTI incidence gradually reduced significantly over time from 6.13 × 1000 patients/year in year 2000 to 0.23 × 1000 patients/year in 2010 (p<0.05). Overall mortality was 14%. Logistic regression analysis showed that admission to ICU (p<0.004) and viral load (p<0.029) were independent variables predicting mortality. Conclusion: LRTI is a pathology with a decreasing incidence, probably related to the widespread utilization increased of HAART regimens. lts etiology has also been changing, but with a non negligible mortality, mostly when ICU admission was required.© 2014 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.Cambios en la etiología, incidencia y pronóstico de la infección respiratoria aguda de vías bajas en pacientes infectados por el virus de la inmunodeficiencia humana Infecc Microbiol Clin. 2014;xxx(xx):xxx-xxx así como la necesidad de ingreso en una unidad de cuidados intensivos (UCI). Se estudió la etiología de la IRVB y la incidencia. Finalmente se analizaron la influencia de las variables con la mortalidad a 30 días. Resultados: Se incluyeron un total de 131 pacientes. La edad media fue de 39 ± 9 años. El 72% de los pacientes eran varones y el 18% de los pacientes requirieron ingreso en la UCI. La IRVB más frecuente fue la neumonía por P. jirovecci, seguida de la neumonía bacteriana en 27 y la tuberculosis pulmonar en 20. La incidencia de IRVB se ha ido reduciendo gradualmente de forma significativa, 6,13 × 1.000 pacientes/año en 2000 a 0,23 × 1.000 pacientes/año en 2010 (p < 0,05). El análisis de regresión logística mostró que la única variable que predijo mortalidad fue el ingreso en UCI (p < 0,05; OR: 73,01). Conclusión: La IRVB es una enfermedad cuya incidencia y etiología han ido disminuyendo y cambiando respectivamente, probablemente en relación con la utilización generalizada del TAR. Sin embargo, todavía presenta una mortalidad nada despreciable, que es mayor cuando el paci...

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

Abstract: The use of HAART can prevent deaths among HIV-TB patients, corroborating the efficacy of starting HAART early in individuals with TB.

Cited by 17 publications

References 18 publications

Predictors of HIV Progression to AIDS and Mortality from AIDS and Non- AIDS Related: A Retrospective Cohort Study in Isfahan, Iran

Predictors of HIV Progression to AIDS and Mortality from AIDS and Non- AIDS Related: A Retrospective Cohort Study in Isfahan, Iran

The HIV-Brazil Cohort Study: Design, Methods and Participant Characteristics

Changes in the etiology, incidence and prognosis of acute lower respiratory track infections in human immunodeficiency virus patients

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