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Mortality Among People With HIV Treated for Tuberculosis Based on Positive, Negative, or No Bacteriologic Test Results for Tuberculosis: The IeDEA Consortium
- Source :
- Open Forum Infectious Diseases, Open Forum Infectious Diseases, Oxford University Press, 2020, 7 (1), pp.ofaa006. ⟨10.1093/ofid/ofaa006⟩
- Publication Year :
- 2020
- Publisher :
- Oxford University Press, 2020.
-
Abstract
- Background In resource-constrained settings, many people with HIV (PWH) are treated for tuberculosis (TB) without bacteriologic testing. Their mortality compared with those with bacteriologic testing is uncertain. Methods We conducted an observational cohort study among PWH ≥15 years of age initiating TB treatment at sites affiliated with 4 International epidemiology Databases to Evaluate AIDS consortium regions from 2012 to 2014: Caribbean, Central and South America, and Central, East, and West Africa. The exposure of interest was the TB bacteriologic test status at TB treatment initiation: positive, negative, or no test result. The hazard of death in the 12 months after TB treatment initiation was estimated using a Cox proportional hazard model. Missing covariate values were multiply imputed. Results In 2091 PWH, median age 36 years, 53% had CD4 counts ≤200 cells/mm3, and 52% were on antiretroviral therapy (ART) at TB treatment initiation. The adjusted hazard of death was higher in patients with no test compared with those with positive test results (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.08–2.26). The hazard of death was also higher among those with negative compared with positive tests but was not statistically significant (HR, 1.28; 95% CI, 0.91–1.81). Being on ART, having a higher CD4 count, and tertiary facility level were associated with a lower hazard for death. Conclusions There was some evidence that PWH treated for TB with no bacteriologic test results were at higher risk of death than those with positive tests. Research is needed to understand the causes of death in PWH treated for TB without bacteriologic testing.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Tuberculosis
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
IDLIC
03 medical and health sciences
0302 clinical medicine
Acquired immunodeficiency syndrome (AIDS)
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
Epidemiology
Major Article
adults
Medicine
030212 general & internal medicine
business.industry
Proportional hazards model
Hazard ratio
HIV
medicine.disease
030112 virology
mortality
Confidence interval
3. Good health
Test (assessment)
Infectious Diseases
Oncology
tuberculosis
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
epidemiology
business
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 23288957
- Volume :
- 7
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Open Forum Infectious Diseases
- Accession number :
- edsair.doi.dedup.....5de834733bd69955b9fc95d07cf01089