Mortality Among People With HIV Treated for Tuberculosis Based on Positive, Negative, or No Bacteriologic Test Results for Tuberculosis: The IeDEA Consortium.

HIV adults epidemiology mortality tuberculosis

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 11 09 2019
accepted: 08 01 2020
entrez: 4 2 2020
pubmed: 6 2 2020
medline: 6 2 2020
Statut: epublish

Résumé

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. 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. In 2091 PWH, median age 36 years, 53% had CD4 counts ≤200 cells/mm 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.

Sections du résumé

BACKGROUND 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 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 RESULTS
In 2091 PWH, median age 36 years, 53% had CD4 counts ≤200 cells/mm
CONCLUSIONS 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.

Identifiants

pubmed: 32010735
doi: 10.1093/ofid/ofaa006
pii: ofaa006
pmc: PMC6984675
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofaa006

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR000445
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI096299
Pays : United States
Organisme : NIAID NIH HHS
ID : K08 AI104352
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI096186
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069923
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG059505
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069911
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069919
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL146204
Pays : United States

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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Auteurs

John M Humphrey (JM)

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Philani Mpofu (P)

Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA.

April C Pettit (AC)

Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt Tuberculosis Center, Nashville, Tennessee, USA.

Beverly Musick (B)

Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA.

E Jane Carter (EJ)

Department of Medicine, Brown University School of Medicine, Providence, Rhode Island, USA.

Eugène Messou (E)

University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.
Centre de Prise en Charge de Recherche et de Formation (Aconda-CePReF), Abidjan, Côte d'Ivoire.

Olivier Marcy (O)

University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.
Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.

Brenda Crabtree-Ramirez (B)

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Marcel Yotebieng (M)

The Ohio State University, College of Public Health, Columbus, Ohio, USA.

Kathryn Anastos (K)

Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

Timothy R Sterling (TR)

Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt Tuberculosis Center, Nashville, Tennessee, USA.

Constantin Yiannoutsos (C)

Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA.

Lameck Diero (L)

Department of Medicine, Moi University College of Health Sciences, Eldoret, Kenya.

Kara Wools-Kaloustian (K)

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Classifications MeSH