It appears you don't have support to open PDFs in this web browser. To view this file, Open with your PDF reader
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.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Details
1 Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
2 Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, USA
3 Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt Tuberculosis Center, Nashville, Tennessee, USA
4 Department of Medicine, Brown University School of Medicine, Providence, Rhode Island, USA
5 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
6 University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France; Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
7 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
8 The Ohio State University, College of Public Health, Columbus, Ohio, USA
9 Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
10 Department of Medicine, Moi University College of Health Sciences, Eldoret, Kenya