Tuberculosis-related mortality in people living with HIV in Europe and Latin America: An international cohort study

Daria N. Podlekareva, Anne Marie W Efsen, Anna Schultze, Frank A. Post, Alena M. Skrahina, Alexander Panteleev, Hansjakob Furrer, Robert F. Miller, Marcelo H. Losso, Javier Toibaro, Jose M. Miro, Anna Vassilenko, Enrico Girardi, Mathias Bruyand, Niels Obel, Jens D. Lundgren, Amanda Mocroft, Ole Kirk

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Management of tuberculosis in patients with HIV in eastern Europe is complicated by the high prevalence of multidrug-resistant tuberculosis, low rates of drug susceptibility testing, and poor access to antiretroviral therapy (ART). We report 1 year mortality estimates from a multiregional (eastern Europe, western Europe, and Latin America) prospective cohort study: the TB:HIV study. Methods: Consecutive HIV-positive patients aged 16 years or older with a diagnosis of tuberculosis between Jan 1, 2011, and Dec 31, 2013, were enrolled from 62 HIV and tuberculosis clinics in 19 countries in eastern Europe, western Europe, and Latin America. The primary endpoint was death within 12 months after starting tuberculosis treatment; all deaths were classified according to whether or not they were tuberculosis related. Follow-up was either until death, the final visit, or 12 months after baseline, whichever occurred first. Risk factors for all-cause and tuberculosis-related deaths were assessed using Kaplan-Meier estimates and Cox models. Findings: Of 1406 patients (834 in eastern Europe, 317 in western Europe, and 255 in Latin America), 264 (19%) died within 12 months. 188 (71%) of these deaths were tuberculosis related. The probability of all-cause death was 29% (95% CI 26-32) in eastern Europe, 4% (3-7) in western Europe, and 11% (8-16) in Latin America (p

Original languageEnglish
Pages (from-to)e120-e131
JournalThe Lancet HIV
Volume3
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

ASJC Scopus subject areas

  • Infectious Diseases
  • Epidemiology
  • Immunology
  • Virology

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