The survival rate of tuberculosis patients in HIV-treated cohort of 2008-2018 in Almaty, Kazakhstan

Zhandybayeva, Ainur; Truzyan, Nune; Shahumyan, Elina; Kulzhabaeva, Aizat; Nugmanova, Zhamilya; Denebayeva, Alfiya; Tukeyev, Marat

doi:10.3855/jidc.11955

Cited by 9 publications

(10 citation statements)

References 10 publications

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“…CD4 counts were an important risk factor associated with mortality in co-infected patients. Low CD4 counts at the time of detection of TB is known to be associated with poor survival [20]. Indeed, as with our data, many studies have reported higher mortality in co-infected patients with CD4 counts of <200 cells/mm 3 [26,27].…”

Section: Discussionsupporting

confidence: 87%

“…As seen in our data, the overall mortality during the course of treatment was 18%; this was higher than the pooled proportion (10.9%) found in the meta-analysis of outcomes of HIV-TB infection [18,19]. Other studies, however, have reported a higher mortality in HIV-TB patients particularly in the initial months after diagnosis of TB [12,20]. Huddart and colleagues [18] have also reported that mortality in the sub-group of HIV-TB co-infected individuals was higher than TB patients; however, there are few reports of mortality from India.…”

Section: Discussioncontrasting

confidence: 56%

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Factors associated with mortality in HIV‐TB co‐infected patients during and after the course of TB treatment in high‐burden settings, Mumbai, India: A cohort analysis

Acharya,

Karanjkar,

Bhamre

et al. 2023

Tropical Med Int Health

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BackgroundKnowledge of factors associated with TB mortality during treatment and post treatment will help us develop better monitoring and implementation strategies for TB control. We designed the present study to examine the factors associated with mortality in HIV‐TB co‐infected patients during and after the course of TB treatment.MethodsThis study is a cohort analysis of secondary data collected from 1804 HIV‐TB co‐infected individuals from 16 anti‐retroviral therapy (ART) centres affiliated with the Mumbai Districts AIDS Control Society, Mumbai, India. We used Kaplan Meier survival curves and hazard ratios to estimate the mortality in patients.ResultsThe overall mortality rate in this cohort was 1.14 per 100 per month. The mortality proportion was 18% (95% CI: 16.1%, 20.1%) during treatment and 10.6% (95% CI: 8.9%, 12.5%) in the post‐treatment period. Mortality was significantly higher in those with a CD4 count 0–200 cells/mm3 (HR: 3.04, 95% CI: 2.13, 4.15; p < 0.001), and in patients who were ART naïve and referred to the ART centre with a diagnosis of TB (HR: 1.39, 95% CI: 1.06, 1.82; p = 0.016). Mortality was also significantly higher in the first 6 months after initiation of ART (HR: 1.36, 95% CI: 1.06, 1.75; p = 0.016). A decrease in the CD4 counts from initial levels at start of TB treatment to end of TB treatment was associated with higher mortality in the post‐treatment period.DiscussionThe overall mortality remains high; early identification of TB and HIV disease, and use of rapid point of care tests for diagnosis of TB are needed across all health care facilities. Post‐treatment follow‐up and monitoring is important in HIV‐TB co‐infected patients, and post‐treatment mortality should also be considered as one of the indicators for successful TB control programmes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 56%

Factors associated with mortality in HIV‐TB co‐infected patients during and after the course of TB treatment in high‐burden settings, Mumbai, India: A cohort analysis

Acharya,

Karanjkar,

Bhamre

et al. 2023

Tropical Med Int Health

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“…Over half of the TB/HIV patients from eastern Europe had died during follow-up in our study. This is exceeding the mortality documented in the previous studies reporting long-term follow-up among TB/HIV co-infected patients, where the highest rates described were 5-year mortality at 44% in Kazakhstan and 12-year mortality at 44% in Brazil [4,6]. Other studies from Latin America found five-year all-cause mortality rates in TB/HIV patients between 10 and 14% and a study from China reported a nearly 35% mortality 5 years after completion of TB treatment [3,5,23].…”

Section: Discussionmentioning

confidence: 71%

“…However, data on TB recurrence and long-term mortality among TB/HIV patients in endemic areas is scarce. Studies from Latin America, Central Asia and China found 5-year all-cause mortality rates in TB/HIV patients between 10 and 44% [3][4][5][6]. However, to the best of our knowledge, no study has assessed causes of deaths and/or whether they were TB-related.…”

Section: Introductionmentioning

confidence: 97%

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Kraef

Bentzon

Roen

et al. 2023

Aids

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Background: Eastern Europe has a high burden of Tuberculosis (TB)/HIV-coinfection with high mortality shortly after TB diagnosis. This study assesses TB recurrence, mortality rates and causes of death among TB/HIV patients from Eastern Europe up to 11 years after TB diagnosis. Methods: A longitudinal cohort study of TB/HIV patients enrolled between 2011–2013 (at TB diagnosis) and followed-up until end of 2021. A competing risk regression was employed to assess rates of TB recurrence, with death as competing event. Kaplan-Maier estimates and a multivariable Cox-regression were used to assess long-term mortality and corresponding risk factors. The Coding Causes of Death in HIV methodology was used for adjudication of causes of death. Results: 375 TB/HIV patients were included. 53 (14·1%) were later diagnosed with recurrent TB (incidence rate 3·1/100 person-years of follow-up (PYFU), 95% CI 2·4–4·0) during a total follow-up time of 1713 PYFU. Twenty-three of 33 patients with data on drug-resistance (69·7%) had MDR-TB. More than half with recurrent TB (n = 30/53, 56·6%) died. Overall, 215 (57·3%) died during the follow-up period, corresponding to a mortality rate of 11·4/100 PYFU (95%CI 10·0–13·1). Almost half of those (48·8%) died of TB. The proportion of all TB-related deaths was highest in the first 6 (n = 49/71; 69·0%; p < 0·0001) and 6 – 24 (n = 33/58; 56·9%; p < 0.0001) months of follow-up, compared deaths beyond 24 months (n = 23/85; 26·7%). Conclusion: TB recurrence and TB-related mortality rates in PLWH in Eastern Europe are still concerningly high and continue to be a clinical and public health challenge.

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“…It can be modeled using the Cox proportional hazard regression method. Cox regression is one of the popular methods in survival analysis [3].…”

Section: Introductionmentioning

confidence: 99%

Factors that influence the recovery of TB patients using Cox proportional hazard regression

Kesuma

Sofyan

Rahayu

et al. 2021

J. Nat.

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Tuberculosis (TB) is an infectious disease which is one of the biggest health problems in the world, including Indonesia. The government, through the National Tuberculosis Control program, has made various efforts to control tuberculosis. However, this problem was exacerbated by the dramatic increase in the incidence of tuberculosis. This study aimed to determine the Cox proportional hazard regression model and the factors that affect the cure rate of TB patients. We used medical record data for inpatient TB patients for the period July-December 2017 at dr. Zainoel Abidin Hospital. The results showed that with α = 0.1, the factors that influenced the recovery of TB patients were the type of cough, the symptoms of bloody cough and symptoms of sweating at night. There were 33.93% of patients who did not work. This category included students, domestic helpers, and those who did not work until they suffered from tuberculosis and were treated at dr. Zainoel Abidin Hospital. The hazard ratio (failure ratio) showed that the tendency or cure rate for TB patients who did not experience cough symptoms was 70% greater than patients who experienced phlegm cough symptoms. The cure rate for TB patients who experienced coughing up blood symptoms was 53% greater than patients without these symptoms. The cure rate for TB patients who experienced symptoms of sweating at night was 54% greater than patients who did not sweat at night.

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The survival rate of tuberculosis patients in HIV-treated cohort of 2008-2018 in Almaty, Kazakhstan

Cited by 9 publications

References 10 publications

Factors associated with mortality in HIV‐TB co‐infected patients during and after the course of TB treatment in high‐burden settings, Mumbai, India: A cohort analysis

Factors associated with mortality in HIV‐TB co‐infected patients during and after the course of TB treatment in high‐burden settings, Mumbai, India: A cohort analysis

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Factors that influence the recovery of TB patients using Cox proportional hazard regression

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