Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/10030
Title: Survival of HIV patients with tuberculosis started on simultaneous or deferred HAART in the THRio cohort, Rio de Janeiro, Brazil
Authors: Saraceni, Valeria
Durovni, Betina
Cavalcante, Solange Cesar
Cohn, Silvia
Pacheco, Antonio Guilherme
Moulton, Lawrence H.
Chaisson, Richard E.
Golub, Jonathan E.
Affilliation: Secretaria Municipal de Saúde. Rio de Janeiro, RJ, Brasil
Secretaria Municipal de Saúde. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Secretaria Municipal de Saúde. Rio de Janeiro, RJ, Brasil
Johns Hopkins University School of Medicine. Center for Tuberculosis Research. Baltimore, MD, United States of America
Johns Hopkins Bloomberg School of Public Health. Department of International Health. Baltimore, MD, United States of America
Johns Hopkins University School of Medicine. Center for Tuberculosis Research. Baltimore, MD, United States of America / Johns Hopkins Bloomberg School of Public Health. Department of International Health. Baltimore, MD, United States of America
Fundação Oswaldo Cruz. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil
Johns Hopkins University School of Medicine. Center for Tuberculosis Research. Baltimore, MD, United States of America / Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, United States of America
Abstract: Background: The timing of highly active antiretroviral therapy (HAART) after a tuberculosis diagnosis in HIV-infected patients can affect clinical outcomes and survival. We compared survival after tuberculosis diagnosis in HIV-infected adults who initiated HAART and tuber-culosis therapy simultaneously to those who delayed the start of HAART for at least twomonths. Methods: The THRio cohort includes 17,983 patients receiving HIV care in 29 public clinics in Rio de Janeiro, Brazil. HAART-naïve patients at the time of a new TB diagnosis between September 2003 and June 2008 were included. Survival was measured in days from diagnosis of TB. We compared survival among patients who initiated HAART within 60 days of TB treatment (simultaneous – ST) to those who started HAART >60 days of TB treatment ornever started (deferred – DT). Kaplan–Meier plots and Cox proportional hazards regression analyses were conducted. Results: Of 947 patients diagnosed with TB, 572 (60%) were HAART naïve at the time of TB diagnosis; 135 were excluded because of missing CD4 count results. Among the remaining 437 TB patients, 56 (13%) died during follow-up: 25 (10%) among ST patients and 31 (16%)in DT group (p = 0.08). ST patients had lower median CD4 counts at TB diagnosis than DT patients (106 vs. 278, p < 0.001). Cox proportional hazards utilizing propensity score analy-sis showed that DT patients were more likely to die (adjusted HR = 1.89; 95% CI: 1.05–3.40;p = 0.03).
DeCS: HIV
Tuberculosis
Antiretroviral Therapy, Highly Active/statistics & numerical data
Survival
Issue Date: 2014
Publisher: Elsevier
Citation: SARACENI, Valeria et al. Survival of HIV patients with tuberculosis started on simultaneous or deferred HAART in the THRio cohort, Rio de Janeiro, Brazil. Brazilian journal of infectious diseases, Salvador, v.18, n.5, p.491-495, 2014.
DOI: 10.1016/j.bjid.2014.02.004
ISSN: 1413-8670
Copyright: open access
Appears in Collections:INI - Artigos de Periódicos

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