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. © 2013 Anne Marie W. Efsen et al.

Efsen, A., Panteleev, A., Grint, D., Podlekareva, D., Vassilenko, A., Rakhmanova, A., et al. (2013). TB meningitis in HIV-positive patients in Europe and Argentina: Clinical dutcome and factors associated with mortality. BIOMED RESEARCH INTERNATIONAL [10.1155/2013/373601].

TB meningitis in HIV-positive patients in Europe and Argentina: Clinical dutcome and factors associated with mortality

GORI, ANDREA
2013

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. © 2013 Anne Marie W. Efsen et al.
Articolo in rivista - Articolo scientifico
Adult; Argentina; CD4 Lymphocyte Count; Europe; Female; HIV; HIV Infections; Humans; Kaplan-Meier Estimate; Male; Risk Factors; Treatment Outcome; Tuberculosis, Meningeal; Biochemistry, Genetics and Molecular Biology (all); Immunology and Microbiology (all)
English
2013
373601
none
Efsen, A., Panteleev, A., Grint, D., Podlekareva, D., Vassilenko, A., Rakhmanova, A., et al. (2013). TB meningitis in HIV-positive patients in Europe and Argentina: Clinical dutcome and factors associated with mortality. BIOMED RESEARCH INTERNATIONAL [10.1155/2013/373601].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/63546
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