Survival of people living with HIV who defaulted from tuberculosis treatment in a cohort, Recife, Brazil

BMC Infectious Diseases

Research Article

M de F Albuquerque¹  R Cunha²  UR Montarroyos²  D de B Miranda-Filho²  M Maruza³  I Coimbra⁴  HR Lacerda⁵  RAA Ximenes⁶ 

[1] Aggeu Magalhães Research Center/Fiocruz, Av Moraes Rego, s/n – Campos da UFPE - Cidade Universitária, PE CEP: 50670420, Recife, Pernambuco, Brazil;Department of Clinical Medicine, Universidade de Pernambuco, Rua Arnóbio Marques, 310 –Santo Amaro, PE CEP: 50100-130, Recife, Pernambuco, Brazil;Hospital Correia Picanço – HCP - Health State Department, Rua Padre Roma, 149, Tamarineira, PE CEP: 52050-150, Recife, Pernambuco, Brazil;Hospital Universitário Oswaldo Cruz- HUOC- UPE, Rua Arnóbio Marques, 310 –Santo Amaro, PE CEP: 50100-130, Recife, Pernambuco, Brazil;Post-Graduation Program in Tropical Medicine – Universidade Federal de Pernambuco, Hospital das Clínicas - Bl. A - Térreo do HC/UFPE, Av. Prof. Moraes Rego - s/n. - Cidade Universitária, PE CEP: 50670-901, Recife, Pernambuco, Brazil;Post-Graduation Program in Tropical Medicine – Universidade Federal de Pernambuco, Hospital das Clínicas - Bl. A - Térreo do HC/UFPE, Av. Prof. Moraes Rego - s/n. - Cidade Universitária, PE CEP: 50670-901, Recife, Pernambuco, Brazil;Department of Clinical Medicine, Universidade de Pernambuco, Rua Arnóbio Marques, 310 –Santo Amaro, PE CEP: 50100-130, Recife, Pernambuco, Brazil;

关键词: Survival;    Tuberculosis;    Treatment;    Default;    Death;   

DOI  :  10.1186/s12879-016-2127-5

 received in 2015-10-19, accepted in 2016-12-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTuberculosis is a serious public health problem worldwide. It is the leading cause of death amongst people living with HIV, and default from tuberculosis (TB) treatment in people living with HIV increases the probability of death. The aim of this study was to estimate the survival probability of people living with HIV who default treatment for TB compared to those who complete the treatment.MethodsThis was a longitudinal cohort study of people living with HIV, from June 2007 to December 2013 with two components: a retrospective (for those who started tuberculosis treatment before 2013 for whom failure (death) or censoring occurred before 2013), and prospective (those who started tuberculosis treatment at any time between 2007 and June 2013 and for whom death or censoring occurred after the beginning of 2013), at two referral hospitals for people living with HIV (Correia Picanço Hospital - HCP and at Hospital Universitário Oswaldo Cruz – HUOC), in Recife/PE. A total of 317 patients who initiated TB treatment were studied. Default from TB treatment was defined as any patient who failed to attend their pre-booked return appointment at the health center for more than 30 consecutive days, in accordance with Brazilian Ministry of Health recommendations.ResultsFrom a cohort of 2372 people living with HIV we analyzed 317 patients who had initiated TB treatment. The incidence of death was 5.6 deaths per 100 persons per year (CI 95% 4.5 to 7.08). Independent factors associated with death: default from TB treatment 3.65 HR (95% CI 2.28 to 5.83); CD4 < 200 cells/mm3 2.39 HR (95% CI 1.44 to 3.96); extrapulmonary tuberculosis 1.56 HR (95% CI 0.93 to 2.63); smoking 2.28 HR (95% CI 1.33 to 3.89); alcohol light 0.13 HR (95% CI 0.03 to 0.56).ConclusionThe probability of death in people living with HIV who default TB treatment is approximately four times greater when compared to those who do not default from treatment.

【 授权许可】

CC BY   
© The Author(s). 2017