Survival of a large cohort of HIV-infected tuberculosis patients in the era of highly active antiretroviral treatment

L. Català, A. Orcau, P. García De Olalla, J. P. Millet, A. Rodríguez-Mondragón, J. A. Caylà

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To determine the survival rate, predictive factors and causes of death in a cohort of human immuno Deficiency virus (HIV) infected tuberculosis (TB) patients in the era of highly active antiretroviral treatment (HAART).DESIGN: This retrospective cohort study included all HIV-infected TB patients reported in Barcelona between 1996 and 2006.A survival analysis was conducted based on the Kaplan-Meier estimator and Cox proportional hazards; hazard ratios (HRs) and their 95% confi dence intervals (CIs) were calculated.Causes of death were classify ed using the International Classifi cation of Diseases (ICD) 9 and ICD-10, and defi ned as acquired immuneDeficiency syndrome (AIDS) related, non-AIDS-related or unknown.RESULTS: Of the 792 patients included, 341 (43.1%) died.Survival at 10 years was 47.4% (95%CI 45.2-49.6).Poorer survival was observed in patients aged >30 years (HR 1.6, 95%CI 1.1-2.1), inner-city residents (HR 1.3, 95%CI 1.1-1.7), injecting drug users (HR 1.4, 95%CI 1.1-1.8), those with a non-cavitary radiological pattern (HR 1.5, 95%CI 1.0-2.2), those with <200 CD4/μl (HR 1.8, 95%CI 1.2-2.7) and those diagnosed with AIDS prior to their TB episode (HR 1.85, 95%CI 1.4-2.2).No differences were found for TB treatment (6 vs.9 months) or for anti-tuberculosis drug resistance; 64.8% of the deaths were non-AIDS-related. CONCLUSIONS: Poor survival was observed despite the availability of HAART, and non-AIDS-related mortality was high.Earlier HAART could help address AIDS and non-AIDS-related mortality.

Original languageEnglish (US)
Pages (from-to)263-269
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume15
Issue number2
StatePublished - Feb 1 2011

Keywords

  • AIDS
  • Causes of death
  • Cohort study
  • Cox regression
  • Risk factor
  • Survival analysis
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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  • Cite this

    Català, L., Orcau, A., De Olalla, P. G., Millet, J. P., Rodríguez-Mondragón, A., & Caylà, J. A. (2011). Survival of a large cohort of HIV-infected tuberculosis patients in the era of highly active antiretroviral treatment. International Journal of Tuberculosis and Lung Disease, 15(2), 263-269.