Mortality From HIV and TB Co-Infections Is Higher in Eastern Europe Than in Western Europe and Argentina
April 13, 2010
Noting that TB "is a leading cause of death in HIV-infected patients worldwide," the study authors aimed to evaluate clinical characteristics and outcomes of 1,075 consecutive patients diagnosed with HIV/TB from 2004 to 2006 in Europe and Argentina.
One-year mortality was assessed in patients stratified according to region of residence, and multivariable Cox models were used to determine factors associated with death.
In a multivariable model, the adjusted relative hazard of death was significantly lower in each of the other regions compared with Eastern Europe: 0.34 percent (95 percent confidence interval 0.17-0.65), 0.28 (0.14-0.57), 0.34 (0.15-0.77) in Argentina, Southern Europe and Central/Northern Europe, respectively. Factors significantly associated with increased mortality were CD4 cell count less than 200 cells/µl [2.31 (1.56-3.45)], prior AIDS [1.74 (1.22-2.47)], disseminated TB [2.00 (1.38-2.85)], initiation of TB treatment not including rifamycin, isoniazid and pyrazinamide [1.68 (1.2-2.36)], and rifamycin resistance [2.10 (1.29-3.41)]. "Adjusting for these known confounders did not explain the increased mortality seen in Eastern Europe," noted the investigators.
"The poor outcome of patients with HIV/TB in Eastern Europe deserves further study and urgent public health attention," the researchers concluded.
11.27.2009; Vol. 23, No. 18: P. 2485-2495; The HIV/TB Study Writing Group
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.