PMID: 11326821May 1, 2001Paper

Association between tuberculosis and HIV disease progression in a high tuberculosis prevalence area

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
M BadriGary Maartens

Abstract

Adult human immunodeficiency virus (HIV) clinics affiliated to the University of Cape Town, South Africa. To assess the impact of tuberculosis on HIV-1 disease progression in an area with high tuberculosis prevalence and minimal antiretroviral therapy use. Prospective patient cohort study. Age, race, risk status, CD4+ T-lymphocyte count, history of AIDS, prophylactic co-trimoxazole and antiretroviral therapy were controlled for in a time-dependent Cox proportional hazards regression model. Tuberculosis fulfilling the case definition developed in 158/609 patients in the 5-year observation period. Tuberculosis was associated with an increased risk of AIDS (adjusted risk ratio [RR] = 1.60, 95% confidence interval [CI] 1.08-2.41; P = 0.02) and death (adjusted RR = 2.16, 95% CI 1.29-3.59; P = 0.003). In a stratified analysis, the increased mortality associated with tuberculosis was observed only in patients with CD4+ T-lymphocyte count > 200 cells/microliter and in those without AIDS at baseline. The onset of tuberculosis in HIV-infected patients is associated with an increased risk of AIDS and death. Although a causal link cannot be established in an observational study, our findings support the view that prolonged immune activatio...Continue Reading

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