Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2.
van der Sande, Marianne AB;
Schim van der Loeff, Maarten F;
Bennett, Rachel C;
Dowling, Mary;
Aveika, Akum A;
Togun, Toyin O;
Sabally, Saihou;
Jeffries, David;
Adegbola, Richard A;
Sarge-Njie, Ramu;
+4 more...Jaye, Assan;
Corrah, Tumani;
McConkey, Samuel;
Whittle, Hilton C;
(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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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 x 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 x 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 in those 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.