Treatment outcome, mortality and their predictors among HIV-associated tuberculosis patients

Abstract

Summary The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). This study aims to evaluate the impact of demographic, clinical and laboratory characteristics on the treatment outcome and mortality of TB/HIV co-infected patients in a tertiary TB centre in Iran. In total, 111 patients were recruited from 2004 to 2007. Mycobacteriological studies and demographic, clinical, and laboratory data from all patients were analysed and predictors of unsuccessful outcomes as well as mortality were determined. The mean age for all 111 TB-HIV patients was 38 ± 9 years (range 22–70) and 107 (96.3%) were men; 104 (93.7%) had a history of drug abuse and 96 (86.4%) had a history of imprisonment. The method of HIV transmission was intravenous drug use in 88 (79.3%). Twenty-three (20.7%) had a history of Category 1 (CAT I) TB treatment and six (5.4%) Category 2 (CAT II) treatment. Combination antiretroviral therapy (cART) was given to 48 (43.2%). No significant associations were found between treatment outcomes or mortality and gender, smoking, drug and alcohol abuse, imprisonment, method of transmission, history of CAT I and CAT II treatments, CD4 counts or adverse effects (P > 0.05). Administration of cART led to significantly better outcomes (P <0.001). Lower serum albumin levels and low body weight were significantly associated with mortality.

Clinical and Sociodemographic Risk Factors for Tuberculosis in Human Immunodeficiency Virus Infected Patients

“…Consistent with other studies, (Girardi et al, 2000;Tabarsi et al, 2012) find that using ART, with 2 or 3 drugs, has a protective effect (RR = 0.16 and 0.08 respectively) in relation to those who did not use any scheme or used monotherapy. Tabarsi et al (2012), showed protection through the use of art (P <0.001).…”

“…Consistent with other studies, (Girardi et al, 2000;Tabarsi et al, 2012) find that using ART, with 2 or 3 drugs, has a protective effect (RR = 0.16 and 0.08 respectively) in relation to those who did not use any scheme or used monotherapy. Tabarsi et al (2012), showed protection through the use of art (P <0.001). Another cohort study conducted in Europe and North America 25, in cities with high incidence of Tb (20 cases per 100,000 population), shows that use of art is a protective factor (RR = 0.87), only when ART start with high CD4 count.…”

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

“…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].…”

“…Few studies of AIDS-free HIV-infected individuals in Iran have explored the potential impact of factors influencing the time for progression from HIV to AIDS and from AIDS to AIDS-related death. The only information comes from small, unrepresentative samples of the population [1,[10][11][12][13][14][15][16]. Therefore, this retrospective cohort study was designed and conducted in a high middle-income country to estimate the time from the HIV diagnosis to AIDS progression and the time from the AIDS initiation to the AIDS-related death and non-AIDSrelated death.…”

Drug Abuse in People Living with HIV in the Era of Highly Active Antiretroviral Therapy: A Systematic Review and Meta-Analysis

“…Prevalence estimates of drug abuse in any form were reported in 31 studies (n=101,023 participants), and widely varied between 2.9% [54] and 93.7% [76]. The pooled prevalence of drug abuse was 33.6% (95% CI 28.2 to 39.3, 28,238 participants) (Figure 2).…”