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Tuberculosis treatment survival of HIV positive TB patients on directly observed treatment short-course in Southern Ethiopia: a retrospective cohort study.

Shaweno D, Worku A - BMC Res Notes (2012)

Bottom Line: All patients with TB treatment outcomes other than death were censored, and death was considered as failure.This risk was statistically higher among HIV patients during the continuation phase (p=0.0003), as a result HIV positive TB patients had shorter survival (Log rank test= 6.90, df= 2, p= 0.008).Targeted and comprehensive management of TB/HIV with a strict follow up should be considered through the entire TB treatment period.

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Affiliation: School of Public and Environmental health, Hawassa University, P.O. Box 1560, Hawassa, Ethiopia. debebesh@gmail.com

ABSTRACT

Background: Tuberculosis (TB) and HIV co-infection remains a major public health problem. In spite of different initiatives implemented to tackle the disease, many countries have not reached TB control targets. One of the major attributing reasons for this failure is infection with HIV. This study aims to determine the effect of HIV infection on the survival of TB patients.

Findings: A retrospective cohort study was employed to compare the survival between HIV positive and HIV negative TB patients (370 each) during an eight month directly observed treatment short-course (DOTS) period. TB patient's HIV status was considered as an exposure and follow up time until death was taken as an outcome. All patients with TB treatment outcomes other than death were censored, and death was considered as failure. Cox proportional hazard regression model was used to determine the hazard ratio (HR) of death for each main baseline predictor. TB/HIV co-infected patients were more likely to die; adjusted Hazard Rate (AHR) =1.6, 95%CI (1.01, 2.6) during the DOTS period. This risk was statistically higher among HIV patients during the continuation phase (p=0.0003), as a result HIV positive TB patients had shorter survival (Log rank test= 6.90, df= 2, p= 0.008). The adjusted survival probability was lower in HIV positive TB patients (< 15%) than HIV negative TB patients (> 85%) at the end of the DOTS period (8th month).

Conclusion: TB treatment survival was substantially lower in HIV infected TB patients, especially during the continuation phase. Targeted and comprehensive management of TB/HIV with a strict follow up should be considered through the entire TB treatment period.

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Adjusted survival curve of the study subjects by HIV status, Hawassa Health Center, 2010.
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Figure 2: Adjusted survival curve of the study subjects by HIV status, Hawassa Health Center, 2010.

Mentions: In the adjusted survival curve (adjusted to baseline characteristics in table one), the survival rate of HIV negative TB patients was > 85% at the end of eighth month. But for HIV positive TB patients, the median survival was at about the end of intensive phase, and dropped to < 15% at the end of the study period (8th month) where all the remaining TB patients become censored (Figure 2).


Tuberculosis treatment survival of HIV positive TB patients on directly observed treatment short-course in Southern Ethiopia: a retrospective cohort study.

Shaweno D, Worku A - BMC Res Notes (2012)

Adjusted survival curve of the study subjects by HIV status, Hawassa Health Center, 2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3585495&req=5

Figure 2: Adjusted survival curve of the study subjects by HIV status, Hawassa Health Center, 2010.
Mentions: In the adjusted survival curve (adjusted to baseline characteristics in table one), the survival rate of HIV negative TB patients was > 85% at the end of eighth month. But for HIV positive TB patients, the median survival was at about the end of intensive phase, and dropped to < 15% at the end of the study period (8th month) where all the remaining TB patients become censored (Figure 2).

Bottom Line: All patients with TB treatment outcomes other than death were censored, and death was considered as failure.This risk was statistically higher among HIV patients during the continuation phase (p=0.0003), as a result HIV positive TB patients had shorter survival (Log rank test= 6.90, df= 2, p= 0.008).Targeted and comprehensive management of TB/HIV with a strict follow up should be considered through the entire TB treatment period.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public and Environmental health, Hawassa University, P.O. Box 1560, Hawassa, Ethiopia. debebesh@gmail.com

ABSTRACT

Background: Tuberculosis (TB) and HIV co-infection remains a major public health problem. In spite of different initiatives implemented to tackle the disease, many countries have not reached TB control targets. One of the major attributing reasons for this failure is infection with HIV. This study aims to determine the effect of HIV infection on the survival of TB patients.

Findings: A retrospective cohort study was employed to compare the survival between HIV positive and HIV negative TB patients (370 each) during an eight month directly observed treatment short-course (DOTS) period. TB patient's HIV status was considered as an exposure and follow up time until death was taken as an outcome. All patients with TB treatment outcomes other than death were censored, and death was considered as failure. Cox proportional hazard regression model was used to determine the hazard ratio (HR) of death for each main baseline predictor. TB/HIV co-infected patients were more likely to die; adjusted Hazard Rate (AHR) =1.6, 95%CI (1.01, 2.6) during the DOTS period. This risk was statistically higher among HIV patients during the continuation phase (p=0.0003), as a result HIV positive TB patients had shorter survival (Log rank test= 6.90, df= 2, p= 0.008). The adjusted survival probability was lower in HIV positive TB patients (< 15%) than HIV negative TB patients (> 85%) at the end of the DOTS period (8th month).

Conclusion: TB treatment survival was substantially lower in HIV infected TB patients, especially during the continuation phase. Targeted and comprehensive management of TB/HIV with a strict follow up should be considered through the entire TB treatment period.

Show MeSH
Related in: MedlinePlus