Abstract
Objectives. The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP). Methods. Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately. Results. A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4-61.6%), 12.3% for TBP (8.9-15.7%), and 19.4% for TBEP (16.1-22.6) (P <0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72-9.09), a prior AIDS diagnosis (aIRR = 4.82 (2.61-8.92)), and receiving care in Eastern Europe (aIRR = 5.41 (2.58-11.34))). Conclusions. TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.
| Original language | English |
|---|---|
| Article number | 373601 |
| Journal | BioMed Research International |
| Volume | 2013 |
| DOIs | |
| Publication status | Published - 2013 |
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ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
- Immunology and Microbiology(all)
Cite this
TB meningitis in HIV-positive patients in Europe and Argentina : Clinical dutcome and factors associated with mortality. / Efsen, Anne Marie W; Panteleev, Alexander M.; Grint, Daniel; Podlekareva, Daria N.; Vassilenko, Anna; Rakhmanova, Aza; Zeltina, Indra; Losso, Marcelo H.; Miller, Robert F.; Girardi, Enrico; Caylá, Joan; Post, Frank A.; Miro, Jose M.; Bruyand, Mathias; Furrer, Hansjakob; Obel, Niels; Lundgren, Jens D.; Mocroft, Amanda; Kirk, Ole.
In: BioMed Research International, Vol. 2013, 373601, 2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - TB meningitis in HIV-positive patients in Europe and Argentina
T2 - Clinical dutcome and factors associated with mortality
AU - Efsen, Anne Marie W
AU - Panteleev, Alexander M.
AU - Grint, Daniel
AU - Podlekareva, Daria N.
AU - Vassilenko, Anna
AU - Rakhmanova, Aza
AU - Zeltina, Indra
AU - Losso, Marcelo H.
AU - Miller, Robert F.
AU - Girardi, Enrico
AU - Caylá, Joan
AU - Post, Frank A.
AU - Miro, Jose M.
AU - Bruyand, Mathias
AU - Furrer, Hansjakob
AU - Obel, Niels
AU - Lundgren, Jens D.
AU - Mocroft, Amanda
AU - Kirk, Ole
PY - 2013
Y1 - 2013
N2 - Objectives. The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP). Methods. Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately. Results. A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4-61.6%), 12.3% for TBP (8.9-15.7%), and 19.4% for TBEP (16.1-22.6) (P <0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72-9.09), a prior AIDS diagnosis (aIRR = 4.82 (2.61-8.92)), and receiving care in Eastern Europe (aIRR = 5.41 (2.58-11.34))). Conclusions. TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.
AB - Objectives. The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP). Methods. Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately. Results. A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4-61.6%), 12.3% for TBP (8.9-15.7%), and 19.4% for TBEP (16.1-22.6) (P <0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72-9.09), a prior AIDS diagnosis (aIRR = 4.82 (2.61-8.92)), and receiving care in Eastern Europe (aIRR = 5.41 (2.58-11.34))). Conclusions. TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.
UR - http://www.scopus.com/inward/record.url?scp=84896862405&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896862405&partnerID=8YFLogxK
U2 - 10.1155/2013/373601
DO - 10.1155/2013/373601
M3 - Article
C2 - 24699884
AN - SCOPUS:84896862405
VL - 2013
JO - BioMed Research International
JF - BioMed Research International
SN - 2314-6133
M1 - 373601
ER -