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


Van Der Sande, MA; Schim Van Der Loeff, MF; Bennett, RC; Dowling, M; Aveika, AA; Togun, TO; Sabally, S; Jeffries, D; Adegbola, RA; Sarge-Njie, R; Jaye, A; Corrah, T; McConkey, S; Whittle, HC; (2004) Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2. AIDS (London, England), 18 (14). pp. 1933-1941. ISSN 0269-9370 DOI: https://doi.org/10.1097/00002030-200409240-00009

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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 × 10 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 × 10 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.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 15353979
URI: http://researchonline.lshtm.ac.uk/id/eprint/14419

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