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.
|Citazione:||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.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||Si|
|Titolo:||TB meningitis in HIV-positive patients in Europe and Argentina: Clinical dutcome and factors associated with mortality|
|Autori:||Efsen, A; Panteleev, A; Grint, D; Podlekareva, D; Vassilenko, A; Rakhmanova, A; Zeltina, I; Losso, M; Miller, R; Girardi, E; Caylá, J; Post, F; Miro, J; Bruyand, M; Furrer, H; Obel, N; Lundgren, J; Mocroft, A; Kirk, O; Gori, A|
|Data di pubblicazione:||2013|
|Rivista:||BIOMED RESEARCH INTERNATIONAL|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1155/2013/373601|
|Appare nelle tipologie:||01 - Articolo su rivista|