Matthew J Magee1, Mary Foote2, David M Maggio3, Penelope P Howards4, K M Venkat Narayan5, Henry M Blumberg6, Susan M Ray2, Russell R Kempker2. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: mjmagee@emory.edu. 2. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA. 3. Division of Health Protection, Georgia Department of Public Health, Atlanta, GA. 4. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA. 6. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
Abstract
PURPOSE: To estimate the association between diabetes mellitus (DM) and all-cause mortality during tuberculosis (TB) treatment. METHODS: From 2009 to 2012, a retrospective cohort study among reported TB cases in Georgia was conducted. Patients aged 16 years or older were classified by DM and human immunodeficiency virus (HIV) status at the time of TB diagnosis and followed during TB treatment to assess mortality. Hazard ratios were used to estimate the association between DM and death. RESULTS: Among 1325 patients with TB disease, 151 (11.4%) had DM, 147 (11.1%) were HIV-infected, and seven (0.5%) had both DM and HIV. Patients with TB-DM were more likely to have cavitary lung disease compared with those with TB alone (51.0% vs. 34.7%) and those with TB-HIV were more likely to have military/disseminated disease (12.9% vs. 3.4%) and resistance to rifampin or isoniazid (21.8% vs. 9.0%) compared with those without HIV infection (P < .05). In multivariable analysis, DM was not associated with death during TB treatment (hazard ratio, 1.22; 95% confidence interval, 0.70-2.12) or any death (adjusted odds ratio, 1.05; 95% confidence interval, 0.60-1.84). CONCLUSIONS: Among TB patients in Georgia, the prevalence of comorbid DM and coinfection with HIV was nearly identical. In adjusted models, TB patients with DM did not have increased risk of all-cause mortality.
PURPOSE: To estimate the association between diabetes mellitus (DM) and all-cause mortality during tuberculosis (TB) treatment. METHODS: From 2009 to 2012, a retrospective cohort study among reported TB cases in Georgia was conducted. Patients aged 16 years or older were classified by DM and human immunodeficiency virus (HIV) status at the time of TB diagnosis and followed during TB treatment to assess mortality. Hazard ratios were used to estimate the association between DM and death. RESULTS: Among 1325 patients with TB disease, 151 (11.4%) had DM, 147 (11.1%) were HIV-infected, and seven (0.5%) had both DM and HIV. Patients with TB-DM were more likely to have cavitary lung disease compared with those with TB alone (51.0% vs. 34.7%) and those with TB-HIV were more likely to have military/disseminated disease (12.9% vs. 3.4%) and resistance to rifampin or isoniazid (21.8% vs. 9.0%) compared with those without HIV infection (P < .05). In multivariable analysis, DM was not associated with death during TB treatment (hazard ratio, 1.22; 95% confidence interval, 0.70-2.12) or any death (adjusted odds ratio, 1.05; 95% confidence interval, 0.60-1.84). CONCLUSIONS: Among TB patients in Georgia, the prevalence of comorbid DM and coinfection with HIV was nearly identical. In adjusted models, TB patients with DM did not have increased risk of all-cause mortality.
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