Mortality Among People With HIV Treated for Tuberculosis Based on Positive, Negative, or No Bacteriologic Test Results for Tuberculosis: The IeDEA Consortium
Year: 2020
Type: article
Study design: Observational Study
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: , 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.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofaa006
Institutions: Indiana University School of Medicine, Indiana University Indianapolis, Indiana University, Vanderbilt University Medical Center, Brown University, Université de Bordeaux, Inserm, Bordeaux Population Health, Institut Pasteur du Cambodge, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, The Ohio State University, Albert Einstein College of Medicine, Moi University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
Funders: United States Agency for International Development, U.S. President’s Emergency Plan for AIDS Relief, National Institute for Medical Research, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences
Awards: Tuberculosis Risk and Highly Active Antiretroviral Therapy Initiation, Acute Effects of Cannabis on Cognition and Mobility in Older HIV-Infected and Uninfected Women", G2611662874, leDEA Networks Coordinating Center at Vanderbilt, The Vanderbilt Institute for Clinical and Translational Research (VICTR), Central Africa International Epidemiology databases to Evaluate AIDS, East Africa International Epidemiology Database to evaluate AIDS (IeDEA) Regional Consortium, Caribbean, Central, and South America network for HIV Epidemiology (CCASAnet), International Epidemiology Databases to EvaluateAIDS (IeDEA) Renewal 4, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS)
OpenAlex ID: W2922379491