Zaw Zaw Aung1, Yu Mon Saw2, Thu Nandar Saw3, Nwe Oo4, Hnin Nwe Ni Aye5, Sithu Aung6, Htun Nyunt Oo7, Su Myat Cho8, Moe Khaing9, Tetsuyoshi Kariya8, Eiko Yamamoto8, Nobuyuki Hamajima8. 1. National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan. 2. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan. Electronic address: sawyumon@med.nagoya-u.ac.jp. 3. Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar. 5. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Mandalay Regional Public Health Department, Ministry of Health and Sports, Mandalay, Myanmar. 6. National Tuberculosis Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar. 7. National AIDS Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar. 8. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan. 9. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar.
Abstract
BACKGROUND: Myanmar is listed as one of the countries with the highest burden of tuberculosis and HIV infections (TB-HIV) in the world. However, the survival rate and risk factors for mortality among TB-HIV co-infected patients in the country remain unstudied. Therefore, the purpose of this study was to examine these factors. METHODS: A 12-year retrospective follow-up study was conducted among 3598 TB-HIV co-infected patients (2452 male and 1146 female) aged 15 years and above, enrolled on antiretroviral therapy (ART) from July 1, 2005 to December 31, 2016. Hazard ratios (HR) were estimated using the Cox proportional hazards model. Survival rates at the beginning of ART were calculated using the Kaplan-Meier method. RESULTS: A total of 494 (13.7%) patients died during this period. The survival rate of TB-HIV co-infected patients was 82.0% at 5 years and 58.1% at 10 years. The risk factors for mortality were being bedridden (adjusted hazard ratio (aHR) 2.70, 95% confidence interval (CI) 2.13-3.42), having a low baseline CD4 count (aHR 1.53, 95% CI 1.25-1.87), and being on a second-line ART regimen (aHR 8.12, 95% CI 3.56-18.54). CONCLUSIONS: Two out of five TB-HIV patients died within 10 years after ART initiation. Current HIV prevention and treatment programs should focus more on bedridden patients, those on second-line ART, and those with low baseline CD4 counts.
BACKGROUND: Myanmar is listed as one of the countries with the highest burden of tuberculosis and HIV infections (TB-HIV) in the world. However, the survival rate and risk factors for mortality among TB-HIV co-infectedpatients in the country remain unstudied. Therefore, the purpose of this study was to examine these factors. METHODS: A 12-year retrospective follow-up study was conducted among 3598 TB-HIV co-infectedpatients (2452 male and 1146 female) aged 15 years and above, enrolled on antiretroviral therapy (ART) from July 1, 2005 to December 31, 2016. Hazard ratios (HR) were estimated using the Cox proportional hazards model. Survival rates at the beginning of ART were calculated using the Kaplan-Meier method. RESULTS: A total of 494 (13.7%) patients died during this period. The survival rate of TB-HIV co-infectedpatients was 82.0% at 5 years and 58.1% at 10 years. The risk factors for mortality were being bedridden (adjusted hazard ratio (aHR) 2.70, 95% confidence interval (CI) 2.13-3.42), having a low baseline CD4 count (aHR 1.53, 95% CI 1.25-1.87), and being on a second-line ART regimen (aHR 8.12, 95% CI 3.56-18.54). CONCLUSIONS: Two out of five TB-HIVpatients died within 10 years after ART initiation. Current HIV prevention and treatment programs should focus more on bedridden patients, those on second-line ART, and those with low baseline CD4 counts.
Authors: Lee Sing Chet; Siti Azrin Ab Hamid; Norsa'adah Bachok; Suresh Kumar Chidambaram; Wan Nor Asyikeen Wan Adnan Journal: Saudi J Med Med Sci Date: 2021-04-29
Authors: Joseph Baruch Baluku; Joseph Musaazi; Rose Mulwana; Araali Robert Mugabo; Felix Bongomin; Winceslaus Katagira Journal: Res Rep Trop Med Date: 2020-06-25