BACKGROUND: In sub-Saharan Africa, tuberculosis (TB) is the most frequently diagnosed opportunistic infection and cause of death among HIV-infected patients. HIV-2 has been associated with less immune suppression, slower disease progression and longer survival. OBJECTIVE: To examine whether the incidence of TB and survival after TB are associated with CD4 cell count rather than HIV type. METHODS: Clinical and immunological data were retrospectively evaluated among an open clinic-based cohort of HIV-1- and HIV-2-infected patients to determine incidence of TB (first diagnosis > 28 days after HIV diagnosis) and subsequent mortality. Patients were grouped by CD4 cell count into those with < 200, 200-500 and > 500 x 10 cells/l. RESULTS: Incident TB was diagnosed among 159 of 2012 patients, with 4973 person-years of observation time. In 105/159 (66.0%), the diagnosis was confirmed by direct microscopy or culture. Incidence of TB was highest in the group with < 200 x 10 cells/l (9.1/100 and 8.8/100 person-years in HIV-1 and HIV-2, respectively). Adjusted for CD4 cell count, there was no significant difference in incidence or mortality following TB between HIV-1- and HIV-2-infected patients. Mortality rate was higher in those with incident TB and HIV infection, most markedly in the group with the highest CD4 cell count (hazard ratio, 10.0; 95% confidence interval, 5.1-19.7). CONCLUSION: Adjusted for CD4 cell count, incidence of TB was similar among HIV-1- and HIV-2-infected patients. Mortality rates after TB diagnosis were similar in both groups and high compared with those without TB.
BACKGROUND: In sub-Saharan Africa, tuberculosis (TB) is the most frequently diagnosed opportunistic infection and cause of death among HIV-infectedpatients. HIV-2 has been associated with less immune suppression, slower disease progression and longer survival. OBJECTIVE: To examine whether the incidence of TB and survival after TB are associated with CD4 cell count rather than HIV type. METHODS: Clinical and immunological data were retrospectively evaluated among an open clinic-based cohort of HIV-1- and HIV-2-infectedpatients to determine incidence of TB (first diagnosis > 28 days after HIV diagnosis) and subsequent mortality. Patients were grouped by CD4 cell count into those with < 200, 200-500 and > 500 x 10 cells/l. RESULTS: Incident TB was diagnosed among 159 of 2012 patients, with 4973 person-years of observation time. In 105/159 (66.0%), the diagnosis was confirmed by direct microscopy or culture. Incidence of TB was highest in the group with < 200 x 10 cells/l (9.1/100 and 8.8/100 person-years in HIV-1 and HIV-2, respectively). Adjusted for CD4 cell count, there was no significant difference in incidence or mortality following TB between HIV-1- and HIV-2-infectedpatients. Mortality rate was higher in those with incident TB and HIV infection, most markedly in the group with the highest CD4 cell count (hazard ratio, 10.0; 95% confidence interval, 5.1-19.7). CONCLUSION: Adjusted for CD4 cell count, incidence of TB was similar among HIV-1- and HIV-2-infectedpatients. Mortality rates after TB diagnosis were similar in both groups and high compared with those without TB.
Authors: A B Schwartz; N Tamuhla; A P Steenhoff; K Nkakana; R Letlhogile; T R Chadborn; M Kestler; N M Zetola; S Ravimohan; G P Bisson Journal: Int J Tuberc Lung Dis Date: 2013-10 Impact factor: 2.373
Authors: Asha Anandaiah; Keertan Dheda; Joseph Keane; Henry Koziel; David A J Moore; Naimish R Patel Journal: Am J Respir Crit Care Med Date: 2010-12-22 Impact factor: 21.405
Authors: Martha Alemayehu; Baye Gelaw; Ebba Abate; Liya Wassie; Yeshambel Belyhun; Shiferaw Bekele; Russell R Kempker; Henry M Blumberg; Abraham Aseffa Journal: Int J Mycobacteriol Date: 2014-03-24
Authors: P Tabarsi; E Chitsaz; A Moradi; P Baghaei; P Farnia; M Marjani; M Shamai; M Amiri; S Nikaein; D Mansouri; M Masjedi; F Altice Journal: Int J STD AIDS Date: 2012-09 Impact factor: 1.359
Authors: Conrad Kabali; Lillian Mtei; Daniel R Brooks; Richard Waddell; Muhammad Bakari; Mecky Matee; Robert D Arbeit; Kisali Pallangyo; C Fordham von Reyn; C Robert Horsburgh Journal: Tuberculosis (Edinb) Date: 2013-03-22 Impact factor: 3.131
Authors: David J Horne; Rebecca Hubbard; Masahiro Narita; Alexia Exarchos; David R Park; Christopher H Goss Journal: BMC Infect Dis Date: 2010-08-27 Impact factor: 3.090
Authors: Maxwell O Akanbi; Chad J Achenbach; Joe Feinglass; Babafemi Taiwo; Adamu Onu; Mai T Pho; Oche Agbaji; Phyllis Kanki; Robert L Murphy Journal: AIDS Res Hum Retroviruses Date: 2013-02-25 Impact factor: 2.205