Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/20621
Title: Influence of HIV Infection on Mortality in a Cohort of Patients Treated for Tuberculosis in the Context of Wide Access to HAART, in Rio de Janeiro, Brazil
Authors: Schmaltz, Carolina Arana Stanis
Sant`Anna, Flávia Marinho
Neves, Simone Carvalho
Velasque, Luciane de Souza
Lourenço, Maria Cristina
Morgado, Mariza Gonçalves
Rolla, Valéria Cavalcanti
Lopes, Guilherme Santoro
Affilliation: Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Pesquisa Clínica em Microbacterioses. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Pesquisa Clínica em Microbacterioses. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Pesquisa Clínica em Microbacterioses. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Pesquisa Clínica em Microbacterioses. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Bacteriologia. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. .Laboratório de Pesquisa Clínica em Microbacterioses. Rio de Janeiro, RJ. Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Clínica de Doenças Infecciosas. Rio de Janeiro, RJ, Brasil.
Abstract: Objective: To analyze the influence of HIV serostatus on mortality related to tuberculosis (TB) in the context of wide access to highly active antiretroviral therapy (HAART) in a middle-income country. Methods: Prospective cohort study including patients who started antituberculous therapy between April 2000 and July 2005 at a referral center in Rio de Janeiro, Brazil. Results: Two hundred seven patients were enrolled, 106 were seropositive for HIV. There were 21 TB-related deaths in HIVpositive subjects (24.7 deaths per 100 patient-years) and 2 (2.5 deaths per 100 patient-years) among HIV-negative patients (rate ratio = 9.76, P , 0.001). Among HIV-infected subjects, TB-related mortality tended to be lower in patients treated with HAART [hazard ratio (HR) = 0.58, P = 0.06]. However, mortality among patients treated with HAARTwas still significantly increased as compared with HIVnegative patients (HR = 6.6, P = 0.014). In a Cox regression model adjusted for disseminated TB (P = 0.04), and treatment with antituberculous regimens not containing rifampicin (P = 0.11), mortality was significantly higher among seropositive patients not on HAART compared with HIV-negative subjects (HR = 6.30, P = 0.024). Among subjects treated with HAART, there was a nonsignificant increase in mortality (rate ratio = 3.48, P = 0.14). Conclusions: HIV infection still has a substantial impact on TB-related mortality in the context of wide access to HAART in a middle-income country.
Keywords: Brazil
HAART
HIV
Mortality
Tuberculosis
keywords: Brasil
HIV
Mortalidade
Tuberculose
Terapia Antirretroviral de Alta Atividade
Issue Date: 2009
Publisher: Lippincott, Williams & Wilkins
Citation: SCHMALTZ, Carolina Arana Stanis; et al. Influence of HIV Infection on Mortality in a Cohort of Patients Treated for Tuberculosis in the Context of Wide Access to HAART, in Rio de Janeiro, Brazil. J. Acquir Immune Defic Syndr, v.52, n.5, p.623–628, Dec. 2009.
ISSN: 1525-4135
Copyright: restricted access
Appears in Collections:IOC - Artigos de Periódicos

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