Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2

Marianne A.B. Van Der Sande, Maarten F. Schim Van Der Loeff, Rachel C. Bennett, Mary Dowling, Akum A. Aveika, Toyin O. Togun, Saihou Sabally, David Jeffries, Richard A. Adegbola, Ramu Sarge-Njie, Assan Jaye, Tumani Corrah, Samuel McConkey, Hilton C. Whittle

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In sub-Saharan Africa, tuberculosis (TB) is the most frequently diagnosed opportunistic infection and cause of death among HIV-infected patients. HIV-2 has been associated with less immune suppression, slower disease progression and longer survival. Objective: To examine whether the incidence of TB and survival after TB are associated with CD4 cell count rather than HIV type. Methods: Clinical and immunological data were retrospectively evaluated among an open clinic-based cohort of HIV-1- and HIV-2-infected patients to determine incidence of TB (first diagnosis > 28 days after HIV diagnosis) and subsequent mortality. Patients were grouped by CD4 cell count into those with < 200, 200-500 and > 500 × 106 cells/l. Results: Incident TB was diagnosed among 159 of 2012 patients, with 4973 person-years of observation time. In 105/159 (66.0%), the diagnosis was confirmed by direct microscopy or culture. Incidence of TB was highest in the group with < 200 × 106 cells/l (9.1/100 and 8.8/100 person-years in HIV-1 and HIV-2, respectively). Adjusted for CD4 cell count, there was no significant difference in incidence or mortality following TB between HIV-1- and HIV-2-infected patients. Mortality rate was higher inthose with incident TB and HIV infection, most markedly in the group with the highest CD4 cell count (hazard ratio, 10.0; 95% confidence interval, 5.1-19.7). Conclusion: Adjusted for CD4 cell count, incidence of TB was similar among HIV-1-and HIV-2-infected patients. Mortality rates after TB diagnosis were similar in both groups and high compared with those without TB.

Original languageEnglish (US)
Pages (from-to)1933-1941
Number of pages9
JournalAIDS
Volume18
Issue number14
DOIs
StatePublished - Sep 24 2004
Externally publishedYes

Keywords

  • CD4 cell
  • Epidemiology
  • HIV-1
  • HIV-2
  • Incidence
  • Natural history
  • Survival
  • Tuberculosis
  • West Africa

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2'. Together they form a unique fingerprint.

Cite this